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General NPI Number Information
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NPI Number | 1528122751
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Entity Type | Individual
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Provider Name | MARK A JOHNSON MD
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Gender | Male
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 2211 QUEEN ANNE AVE N
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City | SEATTLE
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State | WA
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Zip | 98109-2313
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Country | US
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Telephone | 206-861-8500
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Fax | 206-861-8501
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Provider Business Mailing Address
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Address Line | PO BOX 84026
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City | SEATTLE
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State | WA
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Zip | 98124-8426
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Country | US
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Telephone | 206-861-8500
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Fax | 206-861-8501
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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 | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | MD00042851
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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 | MD00042851
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License Number State | WA
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