Provider Demographics
NPI:1144656802
Name:KNABEL, DAVID SEAN (PA-C)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:SEAN
Last Name:KNABEL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HIGHLINE DR
Mailing Address - Street 2:
Mailing Address - City:E WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-5341
Mailing Address - Country:US
Mailing Address - Phone:509-884-0614
Mailing Address - Fax:
Practice Address - Street 1:16811 SE MCGILLIVRAY BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-3404
Practice Address - Country:US
Practice Address - Phone:360-696-5223
Practice Address - Fax:360-696-5228
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60413017363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1144656802Medicaid
WAP01289942OtherRR MEDICARE
WA1144656802Medicaid