Provider Demographics
NPI:1477501963
Name:KNIPE, THOMAS ALBERT (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:ALBERT
Last Name:KNIPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 MADISON STREET
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:96104-1172
Mailing Address - Country:US
Mailing Address - Phone:206-264-8100
Mailing Address - Fax:
Practice Address - Street 1:1231 116TH AVE NE
Practice Address - Street 2:SUITE 915
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3804
Practice Address - Country:US
Practice Address - Phone:425-454-3938
Practice Address - Fax:425-454-2568
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00046371207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0254303OtherL & I
WAG8885387OtherMEDICARE PTAN
WAG8860982Medicare PIN
WA0209306OtherSTATE L&I
WA0211071OtherSTATE L&I
WA0209303OtherSTATE CRIME VICTIMS
WA8860980Medicare PIN
WA8860979Medicare PIN
WAG8860979Medicare PIN
WA0211070OtherSTATE L&I
WA8941542OtherSTATE CRIME VICTIMS
WA8452971Medicaid
WA8860981Medicare PIN
WA8860982Medicare PIN
WA0223170OtherSTATE L&I
I57120Medicare UPIN
WAG8860981Medicare PIN