Provider Demographics
NPI:1285859561
Name:KNOWLTON, EDITH KATHERINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:EDITH
Middle Name:KATHERINE
Last Name:KNOWLTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 1ST AVE S
Mailing Address - Street 2:SUITE 333
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3441
Mailing Address - Country:US
Mailing Address - Phone:206-621-7007
Mailing Address - Fax:206-623-9267
Practice Address - Street 1:216 1ST AVE S
Practice Address - Street 2:SUITE 333
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3441
Practice Address - Country:US
Practice Address - Phone:206-621-7007
Practice Address - Fax:206-623-9267
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1076103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical