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NPI Code Detail

MEDICARE: KATELYN JOY JOHNSON

MEDICARE: KATELYN JOY JOHNSON
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
1225X00000XOccupational TherapistOT.OT.70049209WA

General Provider Information

NPI Number : 1972238582
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN JOY JOHNSON
Provider Business Mailing Address
First Line : 7409 NE HAZEL DELL AVE STE 112
Second Line :
City : VANCOUVER
State : WA
Zip : 98665-8337
Country : US
Telephone Number : 360-597-4048
Fax Number : 360-597-4572
Provider Business Practice Location Address
First Line : 7409 NE HAZEL DELL AVE STE 112
Second Line :
City : VANCOUVER
State : WA
Zip : 98665-8337
Country : US
Telephone Number : 360-597-4048
Fax Number : 360-597-4572
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2022
Last Update Date : 02/10/2026

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Directions to “ KATELYN JOY JOHNSON ” Practice Location

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