Provider Demographics
NPI:1508837378
Name:KNOPF, GREGORY M (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:M
Last Name:KNOPF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1700 SW 257TH AVE
Mailing Address - Street 2:
Mailing Address - City:TROUTDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-1900
Mailing Address - Country:US
Mailing Address - Phone:503-669-6800
Mailing Address - Fax:503-492-1352
Practice Address - Street 1:1700 SW 257TH AVE
Practice Address - Street 2:
Practice Address - City:TROUTDALE
Practice Address - State:OR
Practice Address - Zip Code:97060-1900
Practice Address - Country:US
Practice Address - Phone:503-669-6800
Practice Address - Fax:503-492-1352
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD10780207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR237362Medicaid
OK069013001OtherBLUE CROSS/BLUE SHIELD OR
80103863OtherRAILROAD MEDICARE
911768081OtherODS
911768081OtherUNITED HEALTH CARE
AETNAOther4011975
300411301OtherREGENCE HMO
WA34338OtherWA LABOR & INDUSTRY
911768081OtherHEALTHNET
300411301OtherREGENCE HMO
80103863OtherRAILROAD MEDICARE