Individual
SIDNEY YORKE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDPT
Contact information
Practice address
15837 OTTER POND DR, MOUNT VERNON, WA 98273-8548
(907) 227-6009
Mailing address
15837 OTTER POND DR, MOUNT VERNON, WA 98273-8548
(907) 227-6009
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61278752
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CO61278752
—
WA
Enumeration date
05/12/2022
Last updated
05/12/2022
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