MAXWELL KNAPP
NPI 1174109169
Student in an Organized Health Care Education/Training Program in Portland, OR

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 22, 2021PECOS Enrolled

3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239(503) 494-8311 Get Directions Write a Review

NPPES record last updated: March 22, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Maxwell Knapp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAXWELL KNAPP (NPI 1174109169) is an individual student in an organized health care education/training program in Portland, Oregon and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174109169

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameMAXWELL KNAPP

Location Address3181 SW SAM JACKSON PARK RDPortland, OR 97239-3011

Mailing Address3181 Sw Sam Jackson Park RdPortland, OR 97239-3011

Phone(503) 494-8311

Sole ProprietorNo

Enumeration DateMarch 22, 2021

NPPES CertifiedMarch 22, 2021

✔ NPI 1174109169 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

3181 SW SAM JACKSON PARK RD, Portland, OR 97239

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Maxwell Knapp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.