Provider Demographics
NPI:1922614262
Name:KNOX, BRIANA MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:MARIE
Last Name:KNOX
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:BRIANA
Other - Middle Name:MARIE
Other - Last Name:LAWSON-WHITLOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:70377 E BARLOW TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:RHODODENDRON
Mailing Address - State:OR
Mailing Address - Zip Code:97049-8715
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1800 NE MARKET DR
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:OR
Practice Address - Zip Code:97024-7000
Practice Address - Country:US
Practice Address - Phone:503-660-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201704390LPN164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse