Provider Demographics
NPI:1093315236
Name:KNOTT, STEVEN JON (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:JON
Last Name:KNOTT
Suffix:
Gender:M
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7412 SW BEAVERTON HILLSDALE HWY STE 104
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-2167
Mailing Address - Country:US
Mailing Address - Phone:888-831-5806
Mailing Address - Fax:888-572-0298
Practice Address - Street 1:7412 SW BEAVERTON HILLSDALE HWY STE 104
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-2167
Practice Address - Country:US
Practice Address - Phone:888-831-5806
Practice Address - Fax:888-572-0298
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61127674363LP0808X
OR202011153NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health