Individual
EMILY KNUDSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
603 MEDICAL PKWY, ENTERPRISE, OR 97828-5124
(541) 426-4502
(541) 426-6403
Mailing address
603 MEDICAL PKWY, ENTERPRISE, OR 97828-5124
(541) 426-4502
(541) 426-6403
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD187123
OR
207Q00000X
Family Medicine Physician
MRM-1475
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500750840
—
OR
Enumeration date
05/29/2015
Last updated
12/21/2018
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