Individual
AMANDA DANIELLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
10317 NE 189TH ST APT 65, BOTHELL, WA 98011-3869
(425) 214-2260
Mailing address
10317 NE 189TH ST APT 65, BOTHELL, WA 98011-3869
(425) 214-2260
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00023919
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7084650
—
WA
Enumeration date
03/27/2008
Last updated
01/02/2013
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