Provider Demographics
NPI:1720439037
Name:KNECHTGES, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:KNECHTGES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14600 NW CORNELL ROAD
Mailing Address - Street 2:LIFEWORKS NW
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97229-9415
Mailing Address - Country:US
Mailing Address - Phone:503-645-3581
Mailing Address - Fax:503-629-8517
Practice Address - Street 1:14255 SW BRIGADOON CT.
Practice Address - Street 2:LIFEWORKS NW
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-8400
Practice Address - Country:US
Practice Address - Phone:503-641-1475
Practice Address - Fax:503-641-8548
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health