Individual
JENNIFER T KNOWLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1322 3RD ST SE STE 240, PUYALLUP, WA 98372-3771
(253) 697-5757
Mailing address
1322 3RD ST SE STE 240, PUYALLUP, WA 98372-3771
(253) 697-5757
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00031278
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0199801
L&I
WA
01
—
3908KN
REGENCE RIDER
WA
01
—
4543880
AETNA PROVIDER ID
WA
05
—
8156523
—
WA
01
—
8906802
L&I CVC
WA
01
—
P00297686
MEDICAID RAILROAD
WA
Enumeration date
10/23/2006
Last updated
01/27/2016
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