Provider Demographics
NPI:1275680936
Name:KNUTSON, MARTIN EUGENE (LMHC)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:EUGENE
Last Name:KNUTSON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8275 166TH AVE NE STE 200
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-6629
Mailing Address - Country:US
Mailing Address - Phone:425-869-2644
Mailing Address - Fax:425-867-0930
Practice Address - Street 1:2122 112TH AVE NE STE B200
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-2973
Practice Address - Country:US
Practice Address - Phone:425-869-2644
Practice Address - Fax:425-867-0930
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00011002101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor