Individual
SOPHIA KAYE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDPT
Contact information
Practice address
3165 WA-20 SUITE#1, OAK HARBOR, WA 98277
(360) 697-7676
Mailing address
300 NE 7TH AVE APT A103, OAK HARBOR, WA 98277-2508
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60488344
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO60488344
DEPARTMENT OF HEALTH
WA
01
—
CO60488344
WASHINGTON STATE DEPARTMENT OF HEALTH
—
Enumeration date
02/27/2018
Last updated
06/16/2018
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