Provider Demographics
NPI:1770678500
Name:KNOPF, NANCY SHANNON (QMHP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:SHANNON
Last Name:KNOPF
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3935 SE 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-2926
Mailing Address - Country:US
Mailing Address - Phone:503-516-1533
Mailing Address - Fax:
Practice Address - Street 1:14195 SW MILLIKAN WAY
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2307
Practice Address - Country:US
Practice Address - Phone:503-644-2545
Practice Address - Fax:503-644-0379
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)