Healthcare Provider Details

I. General information

NPI: 1871613612
Provider Name (Legal Business Name): CHRISTOPHER S. JOHNSON MA, AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 06/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE
SEATTLE WA
98104-2499
US

IV. Provider business mailing address

325 9TH AVE BOX 359894
SEATTLE WA
98104-2499
US

V. Phone/Fax

Practice location:
  • Phone: 206-744-3000
  • Fax:
Mailing address:
  • Phone: 206-744-3231
  • Fax: 206-744-8520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberLD00003502
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: