Individual
EMILY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
21525 HWY 410 E STE B, BONNEY LAKE, WA 98391-4101
(253) 826-8520
Mailing address
21525 HWY 410 E STE B, BONNEY LAKE, WA 98391-4101
(253) 826-8520
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A1.60317063
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033581
NATIONAL ATHLETIC TRAINERS ASSOCIATION
—
01
—
A1.60317063
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
04/03/2019
Last updated
04/03/2019
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