Healthcare Provider Details

I. General information

NPI: 1619672557
Provider Name (Legal Business Name): HEATHER N JOHNSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6926 NE FOURTH PLAIN BLVD
VANCOUVER WA
98661-7254
US

IV. Provider business mailing address

915 NW VINCA LN
CAMAS WA
98607-7914
US

V. Phone/Fax

Practice location:
  • Phone: 360-993-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP70075125
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: