Healthcare Provider Details

I. General information

NPI: 1568314193
Provider Name (Legal Business Name): CATHARINA JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2026
Last Update Date: 02/14/2026
Certification Date: 02/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3315 S 23RD ST
TACOMA WA
98405-1605
US

IV. Provider business mailing address

3435 WOODSIDE CT NE
OLYMPIA WA
98506-3685
US

V. Phone/Fax

Practice location:
  • Phone: 253-993-5086
  • Fax:
Mailing address:
  • Phone: 564-250-1085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.70077732
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: