Individual
SUE ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
849 SPRING ST, #1, FRIDAY HARBOR, WA 98250-9376
(360) 370-5226
(360) 370-5559
Mailing address
486 BYRON RD, FRIDAY HARBOR, WA 98250-6967
(360) 378-3214
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00002660
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0184889
L&I INDIVIDUAL NUMBER
WA
01
—
7697576
AETNA
WA
01
—
7822JO
REGENCE INDIVIDUAL RIDER
WA
05
—
8396921
—
WA
Enumeration date
06/28/2006
Last updated
07/09/2007
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