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NPI Code Detail

MEDICARE: EMMA JOHNSSON RD, CD

MEDICARE:   EMMA  JOHNSSON  RD, CD
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
1133V00000XRegistered DietitianDIET.DI.70065557WA

General Provider Information

NPI Number : 1578407292
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMMA JOHNSSON RD, CD
Provider Business Mailing Address
First Line : 17415 17TH PL NE
Second Line :
City : SHORELINE
State : WA
Zip : 98155-5201
Country : US
Telephone Number : 425-233-9234
Fax Number :
Provider Business Practice Location Address
First Line : 325 9TH AVE
Second Line :
City : SEATTLE
State : WA
Zip : 98104-2499
Country : US
Telephone Number : 206-744-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2026
Last Update Date : 04/14/2026

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Directions to “ EMMA JOHNSSON RD, CD” Practice Location

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