Individual provider Active NPI

Kelly Sue Knutson, CRNA

  • Certified Registered Nurse Anesthetist
  • Renton, WA
National Provider Identifier
1609015676
Registry record updated Feb 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP60073256 Issued in WA
Practice address
400 S 43Rd St
Renton, WA 98055-5714
Phone
(800) 540-1814
NPI assigned
Feb 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP60073256 WA Primary

Addresses

Primary practice location

400 S 43Rd St
Renton, WA 98055-5714

Mailing address

PO Box 4069
Everett, WA 98204-0007
Phone (425) 353-3788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090323000341 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3971660762 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paceline Anesthesia, PLLCGroup PAC ID 5799853099, 36 clinicians
Washington Gastroenterology PLLCGroup PAC ID 6204194848, 142 clinicians

Practice addresses (Care Compare)

1135 116TH Ave NE
Suite 570
Bellevue, WA 98004-4632
Phone (425) 451-7335

1301 4TH Ave NE
Suite 301
Issaquah, WA 98027-9369
Phone (425) 454-4768

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP60073256WAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Gastroenterology PLLC CurrentSince Apr 1, 2020 Accepting new patients
Valley Anesthesia Associates, PLLC CurrentSince Mar 5, 2009 Accepting new patients
Washington Gastroenterology PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2020 Accepting new patients
Paceline Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2019 Accepting new patients

Locations

1135 116th Ave NE
Ste 560
Bellevue, WA 98004
Phone (425) 467-0150

1135 116th Ave NE
Ste 570
Bellevue, WA 98004
Phone (425) 451-7335

1135 116th Ave NE
Ste 400
Bellevue, WA 98004
Phone (425) 454-4644

1900 Cooks Hill Rd
Centralia, WA 98531
Phone (360) 330-8627

12800 Bothell Everett Hwy
Ste 200
Everett, WA 98208
Phone (206) 259-3122

5801 Soundview Dr
Ste 156
Gig Harbor, WA 98335
Phone (253) 268-0720

1301 4th Ave NW
Ste 301
Issaquah, WA 98027
Phone (425) 270-6363

17700 SE 272nd St
Ste 420
Kent, WA 98042
Phone (253) 639-9660

2100 Little Mountain Ln
Mount Vernon, WA 98274
Phone (360) 416-6735

1703 S Meridian
Ste 305
Puyallup, WA 98371
Phone (253) 841-3933

1703 S Meridian
Ste 203
Puyallup, WA 98371
Phone (253) 841-3933

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

1101 Madison St
Ste 400
Seattle, WA 98104
Phone (206) 505-1230

3209 S 23rd St
Ste 200
Tacoma, WA 98405
Phone (253) 503-2508

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234483200000",
    "number": "1609015676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4069",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982040007",
            "telephone_number": "425-353-3788",
            "fax_number": "425-353-8041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "800-540-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "KELLY",
        "middle_name": "SUE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-13",
        "last_updated": "2009-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60073256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.