MEDICARE: ROSA M JOHNSON ARNP, MN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP30000777	WA

General Provider Information

NPI Number	:	1063410181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSA M JOHNSON ARNP, MN

Provider Business Mailing Address
First Line	:	2111 N NORTHGATE WAY
Second Line	:	STE 217
City	:	SEATTLE
State	:	WA
Zip	:	98133-8419
Country	:	US
Telephone Number	:	206-367-0550
Fax Number	:	206-363-2550

Provider Business Practice Location Address
First Line	:	2111 N NORTHGATE WAY
Second Line	:	STE 217
City	:	SEATTLE
State	:	WA
Zip	:	98133-9018
Country	:	US
Telephone Number	:	206-367-0550
Fax Number	:	206-363-2550

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	02/27/2017

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