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Individual

STAR MARIE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SUDP

Contact information

Practice address
1812 SUMNER AVE, ABERDEEN, WA 98520-4602
(360) 584-5078
(844) 554-3370
Mailing address
380 W HAVEN DR, ELMA, WA 98541-9515
(360) 270-3000

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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