Provider Demographics
NPI:1609865831
Name:KNUTZEN, DANA MICHELLE (MS)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:MICHELLE
Last Name:KNUTZEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11511 CANTERWOOD BLVD NW
Mailing Address - Street 2:STE 45
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-5813
Mailing Address - Country:US
Mailing Address - Phone:253-426-4772
Mailing Address - Fax:253-426-6449
Practice Address - Street 1:11511 CANTERWOOD BLVD NW
Practice Address - Street 2:STE 45
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-5813
Practice Address - Country:US
Practice Address - Phone:253-426-4772
Practice Address - Fax:253-426-6449
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAGT60205856170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS