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General NPI Number Information
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NPI Number | 1578561007
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Entity Type | Individual
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Provider Name | EKATERINA KNOWLTON M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 4033 TALBOT RD S STE 530
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City | RENTON
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State | WA
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Zip | 98055-5700
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Country | US
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Telephone | 425-690-3433
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Fax | 425-690-9433
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Provider Business Mailing Address
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Address Line | 15209 141ST AVE SE
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City | SNOHOMISH
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State | WA
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Zip | 98290-6730
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Country | US
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Telephone | 360-631-0576
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD00038128
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 54947
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD00038128
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License Number State | WA
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