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General NPI Number Information
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NPI Number | 1801324991
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Entity Type | Individual
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Provider Name | MATTHEW ALLEN JOHNSON PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2017
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 2451 NE KRESKY AVE UNIT E
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City | CHEHALIS
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State | WA
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Zip | 98532-2436
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Country | US
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Telephone | 360-262-4352
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Fax | 360-450-3023
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Provider Business Mailing Address
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Address Line | PO BOX 247
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City | GALVIN
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State | WA
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Zip | 98544-0247
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Country | US
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Telephone | 360-262-4352
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Fax | 360-450-3023
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY60489916
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License Number State | WA
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