Healthcare Provider Details

I. General information

NPI: 1801714258
Provider Name (Legal Business Name): CAITLIN JOHNSON PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

701 W 7TH AVE STE 130
SPOKANE WA
99204-2835
US

IV. Provider business mailing address

701 W 7TH AVE STE 130
SPOKANE WA
99204-2835
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-3932
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSYA.PG.70080512
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: