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Individual
STAR MARIE JOHNSON
Active
Individual
STAR MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CO61000223
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP61505739
WA
175T00000X
Peer Specialist
CG60987591
WA
Other
Enumeration date
07/26/2019
Last updated
09/09/2025
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