Healthcare Provider Details

I. General information

NPI: 1326668773
Provider Name (Legal Business Name): KARI KNIGHT DERMATOLOGY AND WELLNESS PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2020
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 N 50TH AVE
YAKIMA WA
98908-2862
US

IV. Provider business mailing address

121 N 50TH AVE
YAKIMA WA
98908-2862
US

V. Phone/Fax

Practice location:
  • Phone: 509-930-7777
  • Fax: 509-420-9843
Mailing address:
  • Phone:
  • Fax: 509-420-9843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KARALEE KNIGHT
Title or Position: NURSE PRACTITIONER
Credential: DCNP
Phone: 509-930-7777