Healthcare Provider Details

I. General information

NPI: 1841258019
Provider Name (Legal Business Name): CALVIN H KNAPP JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 03/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MINOR AVE SUITE 140
SEATTLE WA
98104-2133
US

IV. Provider business mailing address

805 MADISON ST SUITE 901
SEATTLE WA
98104-1172
US

V. Phone/Fax

Practice location:
  • Phone: 206-838-8345
  • Fax: 206-838-8346
Mailing address:
  • Phone: 206-264-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD00027495
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: