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General NPI Number Information
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NPI Number | 1497863005
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Entity Type | Individual
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Provider Name | COURTNEY ROSE JOHNSON MD
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Gender | Female
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 3623 SW ALASKA ST, SUITE 7
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City | SEATTLE
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State | WA
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Zip | 98126
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Country | US
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Telephone | 360-440-8376
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Fax | 360-474-3927
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Provider Business Mailing Address
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Address Line | 3623 SW ALASKA ST STE 7
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City | SEATTLE
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State | WA
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Zip | 98126-2732
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Country | US
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Telephone | 206-278-3930
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Fax | 360-474-3947
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00037773
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 00037773
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License Number State | WA
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