Healthcare Provider Details

I. General information

NPI: 1518873686
Provider Name (Legal Business Name): BETHANY JOY JOHNSON AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 N HAMILTON ST
SPOKANE WA
99207-2763
US

IV. Provider business mailing address

2811 N HAMILTON ST
SPOKANE WA
99207-2763
US

V. Phone/Fax

Practice location:
  • Phone: 509-255-3583
  • Fax:
Mailing address:
  • Phone: 509-255-3583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTA.MG.70128031
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: