| Doctor Name: | MR. JOHN BURTMENT MCKNIGHT |
| NPI Number: | 1235329772 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CADCII |
| License Number: | 99-11-70 |
| Business Practice Address: | 52482 Se 2nd St Scappoose, OR - 970563615 |
| Business Phone Number: | 5035432551 |
| Business Fax Number: | 5035432382 |
| Mailing Address: | 52482 Se 2nd St, SCAPPOOSE |
| State: | OR |
| Postal Code: | 970563615 |
| Phone Number: | 5035432551 |
| Fax Number: | 5035432382 |
| NPI Enumeration Date: | 07/31/2007 |
| NPI Last Update Date: | 07/31/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 99-11-70 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |