Healthcare Provider Details

I. General information

NPI: 1023112471
Provider Name (Legal Business Name): GAIL JOHNSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 01/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6020 35TH AVE SW
SEATTLE WA
98126-3002
US

IV. Provider business mailing address

1200 12TH AVE S SUITE 901
SEATTLE WA
98144-2712
US

V. Phone/Fax

Practice location:
  • Phone: 206-461-6950
  • Fax: 206-461-8542
Mailing address:
  • Phone: 206-548-3114
  • Fax: 206-762-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30001780
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00067960
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: