Active NPI
Bryan John Knobel, PHARMACIST
- Pharmacist
- Vancouver, WA
National Provider Identifier
1255602728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PO00019906
- Practice address
- 6708 NE 63Rd St
Vancouver, WA 98661-1915 - Phone
- (360) 696-0750
- Fax
- (360) 567-1679
- NPI assigned
- Jan 15, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PO00019906 | WA | Primary |
Addresses
Primary practice location
6708 NE 63Rd St
Vancouver, WA 98661-1915
Mailing address
4306 NE 62ND Ave
Vancouver, WA 98661-3028
Phone (360) 993-1107
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PO00019906 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326585600000",
"number": "1255602728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4306 NE 62ND AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986613028",
"telephone_number": "360-993-1107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6708 NE 63RD ST",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986611915",
"telephone_number": "360-696-0750",
"fax_number": "360-567-1679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNOBEL",
"first_name": "BRYAN",
"middle_name": "JOHN",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-01-15",
"last_updated": "2012-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PO00019906",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.