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General NPI Number Information
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NPI Number | 1821191842
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Entity Type | Individual
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Provider Name | BRIAN JOHNSON LMP
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Gender | Male
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 11545 15TH AVE NE STE 305
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City | SEATTLE
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State | WA
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Zip | 98125-6358
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Country | US
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Telephone | 425-343-8267
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Fax | 425-374-3435
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Provider Business Mailing Address
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Address Line | 11132 17TH ST SE
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City | LAKE STEVENS
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State | WA
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Zip | 98258-7939
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Country | US
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Telephone | 425-343-8267
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Fax | 425-374-3435
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA00007753
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License Number State | WA
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