Individual
MS. SUSAN DIANE KNOTTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT LMT
Contact information
Practice address
27025 TRASK RIVER ROAD, TILLAMOOK, OR 97141-0433
(503) 842-7305
(503) 842-0447
Mailing address
27025 TRASK RIVER ROAD, TILLAMOOK, OR 97141-0433
(503) 842-7305
(503) 842-0447
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1387
OR
225700000X
Massage Therapist
1696
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115OR00690
TRICARE
OR
05
—
182803
—
OR
01
—
320438201
PREF CHOICE 65 BCBS
OR
01
—
838546001
BCBS
OR
01
—
838547001
BCBS
OR
Enumeration date
08/31/2006
Last updated
09/12/2008
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