Provider Demographics
NPI:1134991532
Name:KNUTSON, EMILY ELIZABETH (CD,CLC, CRM)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ELIZABETH
Last Name:KNUTSON
Suffix:
Gender:F
Credentials:CD,CLC, CRM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92700 MAGGIE JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-8629
Mailing Address - Country:US
Mailing Address - Phone:360-442-6782
Mailing Address - Fax:
Practice Address - Street 1:3990 ABBEY LN # 102-B
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-2237
Practice Address - Country:US
Practice Address - Phone:360-442-6782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-27
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty