=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770465007
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRIPLE KNOT PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2025
-----------------------------------------------------
Last Update Date | 02/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 307 N OLYMPIC AVE STE 206
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98223-1351
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-229-5954
-----------------------------------------------------
Fax | 360-200-0463
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 307 N OLYMPIC AVE STE 206
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98223-1351
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-229-5954
-----------------------------------------------------
Fax | 360-200-0463
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | HALLIE GRANVILLE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 360-395-5550
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------