Individual provider Active NPI

Cerise R Knakal, CPO

  • Orthotist
  • Olympia, WA
National Provider Identifier
1588287973
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OrthotistTaxonomy code 222Z00000X
License
OI60965930 Issued in WA
Practice address
3508 12TH Ave NE
Olympia, WA 98506-5218
Phone
(360) 459-1099
Fax
(360) 459-1794
NPI assigned
May 20, 2020
Last updated
May 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotist 222Z00000X OI60965930 WA Primary
Prosthetist 224P00000X PS60998413 WA

Addresses

Primary practice location

3508 12TH Ave NE
Olympia, WA 98506-5218

Mailing address

3508 12TH Ave NE
Olympia, WA 98506-5218
Phone (360) 459-1099

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

LicenseStateTypeSpecialty
OI60965930WAMDOrthotist
PS60998413WAMDProsthetist

NPI Registry JSON

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1588287973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 12TH AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065218",
            "telephone_number": "360-459-1099",
            "fax_number": "360-459-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3508 12TH AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065218",
            "telephone_number": "360-459-1099",
            "fax_number": "360-459-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNAKAL",
        "first_name": "CERISE",
        "middle_name": "R",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "WA",
            "license": "OI60965930",
            "primary": true
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "WA",
            "license": "PS60998413",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.