Healthcare Provider Details

I. General information

NPI: 1053726885
Provider Name (Legal Business Name): ASHLEY R JOHNSTON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11400 SE 6TH ST STE 200
BELLEVUE WA
98004-4181
US

IV. Provider business mailing address

9710 STATE AVE
MARYSVILLE WA
98270-2232
US

V. Phone/Fax

Practice location:
  • Phone: 866-535-0488
  • Fax:
Mailing address:
  • Phone: 360-653-1742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOP60758777
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: