Organization
KELLY KNICKERBOCKER ARNP PLLC
Active
Other names
Kelly Knickerbocker ARNP
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SWANSON (ADMINISTRATOR)
(425) 954-3330
Entity
Organization
Contact information
Practice address
23007 LAKEVIEW DRIVE, A203, MOUNTLAKE TERRACE, WA 98043-1117
(425) 954-3330
(425) 249-3107
Mailing address
20126 BALLINGER WAY NE, PMB 89, SHORELINE, WA 98155-1117
(425) 954-3330
(425) 249-3107
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427304138
PROVIDER NPI (NPI 1)
—
Enumeration date
08/20/2020
Last updated
12/07/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us