Provider Demographics
NPI:1093712010
Name:KNOX, KRISTEN KAY (MD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:KAY
Last Name:KNOX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17311 135TH AVE NE
Mailing Address - Street 2:A-700
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-3519
Mailing Address - Country:US
Mailing Address - Phone:425-488-4944
Mailing Address - Fax:425-488-4942
Practice Address - Street 1:17311 135TH AVE NE
Practice Address - Street 2:A-700
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-3519
Practice Address - Country:US
Practice Address - Phone:425-488-4944
Practice Address - Fax:425-488-4942
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00026818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8134637Medicaid
WAAB20867Medicare PIN
WAF10543Medicare UPIN