Healthcare Provider Details

I. General information

NPI: 1376345645
Provider Name (Legal Business Name): RACHAEL LYNN JOHNSON D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4915 25TH AVE NE SEATTLE SPECIAL CARE DENTISTRY STE 205
SEATTLE WA
98105
US

IV. Provider business mailing address

4915 25TH AVE NE SEATTLE SPECIAL CARE DENTISTRY STE 205
SEATTLE WA
98105
US

V. Phone/Fax

Practice location:
  • Phone: 206-524-1600
  • Fax: 206-524-1603
Mailing address:
  • Phone: 206-524-1600
  • Fax: 206-524-1603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: