Healthcare Provider Details

I. General information

NPI: 1780673269
Provider Name (Legal Business Name): MORRIS G. JOHNSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 ROCKEFELLER AVE STE 120
EVERETT WA
98201-1676
US

IV. Provider business mailing address

7600 EVERGREEN WAY
EVERETT WA
98203-6421
US

V. Phone/Fax

Practice location:
  • Phone: 425-339-5442
  • Fax: 425-339-1363
Mailing address:
  • Phone: 206-860-5414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD00019809
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: