Provider Demographics
NPI:1316116718
Name:KNUTH, KAREN ANN (ARNP)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ANN
Last Name:KNUTH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 SAND POINT WAY NE
Mailing Address - Street 2:MAILSTOP CSB-240
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3901
Mailing Address - Country:US
Mailing Address - Phone:206-987-2394
Mailing Address - Fax:206-987-7126
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:MAILSTOP CSB-240
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-2394
Practice Address - Fax:206-987-7126
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00152080163W00000X
WAARNP30008044363LN0000X, 363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8873740Medicare PIN
WAG8878225Medicare PIN