Healthcare Provider Details

I. General information

NPI: 1992332233
Provider Name (Legal Business Name): JOHN KNEEPKENS DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 5TH AVE S STE 200
KIRKLAND WA
98033-6736
US

IV. Provider business mailing address

PO BOX 741515
LOS ANGELES CA
90074-1515
US

V. Phone/Fax

Practice location:
  • Phone: 425-814-5100
  • Fax: 425-814-5103
Mailing address:
  • Phone: 425-814-5100
  • Fax: 425-814-5103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61107649
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60392833
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: