Individual
CASSIDY JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
748 14TH AVE, LONGVIEW, WA 98632-2315
(360) 200-5419
(360) 200-6736
Mailing address
PO BOX 2394, LONGVIEW, WA 98632
(360) 200-5419
(360) 200-6736
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG61033979
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2154143
—
WA
Enumeration date
02/28/2020
Last updated
10/30/2020
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