Healthcare Provider Details

I. General information

NPI: 1184031387
Provider Name (Legal Business Name): KIMBERLY ANNE KNEBEL BSN MBA SANE A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2014
Last Update Date: 07/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE
SEATTLE WA
98104-2420
US

IV. Provider business mailing address

4040 26TH AVE SW APT 411
SEATTLE WA
98106-1294
US

V. Phone/Fax

Practice location:
  • Phone: 206-744-3000
  • Fax:
Mailing address:
  • Phone: 360-281-5314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN00160886
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: