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1427304138
KELLY MARIE KNICKERBOCKER
MOUNTLAKE TERRACE, WA
NPI
1427304138
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: WA AP 60448879)
Enumeration Date
2012-07-31
Last Update Date
2023-12-07
Business Address
KELLY MARIE KNICKERBOCKER MSN RN PMHNP
23007 LAKEVIEW DR UNIT A203
MOUNTLAKE TERRACE, WA 98043-2378
Phone number: 425-954-3330
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Mailing Address
KELLY MARIE KNICKERBOCKER MSN RN PMHNP
11411 NE 124TH ST SUITE 190
KIRKLAND, WA 98034-4314
Phone number: 206-945-7512
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