Healthcare Provider Details

I. General information

NPI: 1174487284
Provider Name (Legal Business Name): CHRISTINE NICOLE JOHNSON MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 N ASSEMBLY ST
SPOKANE WA
99205-6185
US

IV. Provider business mailing address

508 E DALTON AVE
SPOKANE WA
99207-1973
US

V. Phone/Fax

Practice location:
  • Phone: 509-434-7000
  • Fax:
Mailing address:
  • Phone: 360-540-7420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: