Provider Demographics
NPI:1982119517
Name:MCKNIGHT, R. THOMAS JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:R.
Middle Name:THOMAS
Last Name:MCKNIGHT
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:THOMAS
Other - Last Name:MCKNIGHT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 2185
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99210-2185
Mailing Address - Country:US
Mailing Address - Phone:509-473-6003
Mailing Address - Fax:509-473-6704
Practice Address - Street 1:711 S COWLEY ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202
Practice Address - Country:US
Practice Address - Phone:509-473-6003
Practice Address - Fax:509-473-6704
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-05
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA737103T00000X
WAPY00000737103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA737OtherPSYCHOLOGIST