Leah Michelle Knowles, MT

Individual provider Active NPI Contractor · Twisp, WA

NPI 1104042167 · NPPES record last updated Sep 16, 2024

Key facts

NPI
1104042167
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
License
MA00015169 (WA)
Practice address
214 Glover St N
Twisp, WA 98856
Phone
(509) 449-6368
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
MA00015169WAMDContractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X MA00015169 WA Yes

Addresses

Primary practice location

214 Glover St N
Twisp, WA 98856

Mailing address

PO Box 282
Twisp, WA 98856-0282
Phone (509) 449-6368

Other identifiers

IdentifierTypeStateIssuer
0162426OtherWALABOR AND IND PIN

Other providers in Twisp, WA

All providers in Twisp, WA · Contractor in Washington

Sources for this page

Verify at the official NPI Registry.