Cynthia Ackerman Knutson, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD60661694 Issued in WA

Practice address

660 SW 39TH St Ste 150
Renton, WA 98057-4912

Phone

(425) 690-3483

Fax

(425) 690-9083

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Valley Medical Group-Renton

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1619209574

  Family Medicine

  Medicare reassignment NPD
• Northern Arizona Dermatology Center PC

  • Dermatology Physician
  • Flagstaff, AZ
  • NPI 1962558569
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1306863030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 SW 39TH ST STE 150",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574912",
            "telephone_number": "425-690-3483",
            "fax_number": "425-690-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 SW 39TH ST STE 150",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574912",
            "telephone_number": "425-690-3483",
            "fax_number": "425-690-9083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1490 Turquoise Dr",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "86001",
            "country_code": "US",
            "telephone_number": "928-774-5074",
            "fax_number": "928-779-0884",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Madison St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981041306",
            "country_code": "US",
            "telephone_number": "206-505-1300",
            "fax_number": "206-505-1277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "CYNTHIA",
        "middle_name": "ACKERMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "20368",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "WA",
            "license": "MD60661694",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AZ",
            "license": "20368",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "AZ",
            "license": "20368",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD60661694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2074044",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "395021",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "070010620",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "G8983904",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela S Klementson, ARNP
• Chanel Knight
• Christine Knight
• Cara Jeanette Knolles
• Ekaterina Knowlton, M.D.
• Kelly Sue Knutson, CRNA
• George J Ko, MD
• Erich Edward Koerner, M.D.
• Edward Koh
• Jason S Koh, DDS

• Dermatology Physician in Renton, WA
• Providers in Renton, WA by specialty
• Dermatology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.