Healthcare Provider Details

I. General information

NPI: 1992669782
Provider Name (Legal Business Name): JUSTIN MICHAEL JOHNSON LMFTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 HARVEY RD NE STE C
AUBURN WA
98002-4294
US

IV. Provider business mailing address

921 HARVEY RD NE STE C
AUBURN WA
98002-4294
US

V. Phone/Fax

Practice location:
  • Phone: 253-939-2211
  • Fax: 253-939-2867
Mailing address:
  • Phone: 253-939-2211
  • Fax: 253-939-2867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMG70038608
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMG70038608
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: