JOHN R. KNUDSEN (NPI# 1508952060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508952060 |
| Entity Type | Individual |
| Full Name | JOHN R. KNUDSEN |
| Credential | M.D. |
| Practice Address |
6046 Portal Way Ste 103 Ferndale WA 98248-7829 |
| Mailing Address |
1260 Maralee Lane Bellingham WA 98226 |
| Practice Telephone | 3607342330 |
| Practice Fax Number | 3607333886 |
| Mailing Telephone | 3603934142 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2018-01-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
MD00013215 | WA | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | MD00013215 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | L&I | 151150 | 01 |
| WA | CLIA | 50D0856491 | 01 |
| WA | DEA | AK5619664 | 01 |
| WA | REG RYDER | 5824KN | 01 |
| WA | 1466705 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205846557 | John Frederick Knudsen | Dentist | 127 N West St, Ste 1, Easton, MD 21601-2758 | 2006-08-09 |
| 1104852342 | John Knudsen IIi | Anesthesiology | 1515 E 32nd St, Ste 200, Joplin, MO 64804-2912 | 2006-06-22 |
| 1477538379 | John R Knudsen | Family Medicine | 600 W. Jefferson, Kirksville, MO 63501 | 2005-12-13 |
| 1083025878 | John Richard Knudsen | Anesthesiology | 555 S 70th St, Lincoln, NE 68510-2462 | 2014-05-14 |
| 1083688790 | John C. Knudsen | Specialist | 111 N 17th St, Mount Vernon, WA 98273-3440 | 2006-02-17 |
| 1780664268 | John M Knudsen | Radiology | 200 1st St Sw, Rochester, MN 55905-0001 | 2006-01-19 |
| Street Address |
6046 PORTAL WAY STE 103 |
| City | FERNDALE |
| State | WA |
| Zip Code | 98248-7829 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366050833 | Cascade Connections | In Home Supportive Care | 1354 Pacific Place, Suite 101, Ferndale, WA 98248 | 2020-07-21 |
| 1073135976 | Amrit Kaur | Respiratory Therapist, Certified | 6158 North Star Rd, Ferndale, WA 98248 | 2020-05-13 |
| 1437668563 | Marcie Ann Logan | Registered Nurse | 5661 Eagle Parkway, Apt. 4, Ferndale, WA 98248 | 2017-09-20 |
| 1215468640 | Crystal Dawn Phipps | Pharmacist | 5655 3rd Ave., Ferndale, WA 98248 | 2017-03-27 |
| 1295143568 | Marion L Winisky | Registered Nurse | 2350 Douglas Rd #40, Ferndale, WA 98248 | 2014-07-30 |
| 1225472186 | Loops Flexbrush, LLC | Durable Medical Equipment & Medical Supplies | 7152 Everett Rd, Ferndale, WA 98248 | 2013-04-23 |
| 1982984043 | Anthony Allen Gardiner | Dentist | 2030 Alder St, Ferndale, WA 98248 | 2011-08-22 |
| 1942592696 | Norman Tang | Pharmacist | 2057 Alder Street, Ferndale, WA 98248 | 2011-05-12 |
| 1316178692 | Linh T Vu | Dentist | 2086 Main St, Ferndale, WA 98248 | 2009-08-04 |
| 1770724965 | Michael Alexander Glen | Pharmacist | Haggen Food and Pharmacy, 1815 Main Street, Ferndale, WA 98248 | 2009-03-17 |
| Find all providers in zip 98248 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316422454 | Cmdpn Medical Group of Washington, P.C. | Emergency Medicine | 707 West Main Ave. Ste B1, Pmb 117, Spokane, WA 99201 | 2018-09-25 |
| 1740713627 | Anthony Warfield | Emergency Medicine | 120 Republican St, #404, Seattle, WA 98109-4745 | 2017-04-06 |
| 1083877559 | Lisa Marie Wilson | Emergency Medicine | 925 Seneca St., Mailstop H6-ed, Virginia Mason Medical Center, Seattle, WA 98101 | 2008-07-05 |
| 1467574863 | Mark Urmanski | Emergency Medicine | 3700 Martin Way E, Suite 108, Olympia, WA 98506-5052 | 2007-04-04 |
| 1790805190 | Cascade Urgent Care, Inc., Ps | Emergency Medicine | 1413 S 348th Street, L106, Federal Way, WA 98003-8373 | 2007-03-30 |
| 1376574160 | Jeffrey Philip Roger | Emergency Medicine | 2005 Nw Sammamish Road, Issaquah, WA 98027 | 2006-07-06 |
| 1750329777 | Stephani J. Amstadter | Emergency Medicine | 5920 - 100th St. Sw #31, Lakewood, WA 98499-2751 | 2006-06-03 |
| 1922059187 | Stephen E Pohl | Emergency Medicine | Hpo 1, Boone Road, Navy Hospital, Bremerton, WA 98312 | 2006-05-13 |
| 1871569012 | Steven Temerlin | Emergency Medicine | 1717 South J Street, Tacoma, WA 98405-4933 | 2006-02-27 |
| 1669443891 | Robert Bruce Nolan | Emergency Medicine | 1606 N Proctor St, Tacoma, WA 98406-5227 | 2006-01-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.