Individual
AMY R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
801 BROADWAY STE 500, SEATTLE, WA 98122-4396
(206) 215-5921
(206) 215-5922
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60453895
WA
363AM0700X
Medical Physician Assistant
PA60453895
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194003012
—
WA
Enumeration date
07/26/2011
Last updated
02/03/2021
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