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General NPI Number Information
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NPI Number | 1912643255
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Entity Type | Individual
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Provider Name | GARRETT S KNEESE
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Gender | Male
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Dates
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Enumeration Date | 05/10/2022
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 1101 15TH ST NW
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City | WASHINGTON
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State | DC
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Zip | 20005-5002
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Country | US
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Telephone | 833-694-9362
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Fax | 202-379-3570
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Provider Business Mailing Address
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Address Line | 3811 FAIRFAX DR STE 1000
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City | ARLINGTON
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State | VA
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Zip | 22203-1782
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Country | US
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Telephone | 202-741-3570
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD600004156
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License Number State | DC
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