| Doctor Name: | BRIAN R JOHNSON |
| NPI Number: | 1104964188 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | S.P. |
| License Number: | LL00003248 |
| Business Practice Address: | 626 120th Ave Ne Suite B201 Bellevue, WA - 980053077 |
| Business Phone Number: | 4255566330 |
| Business Fax Number: | 4255566325 |
| Mailing Address: | 11511 Ne 10th St, Bellevue Medical Center BELLEVUE |
| State: | WA |
| Postal Code: | 980048578 |
| Phone Number: | 4255023898 |
| Fax Number: | 4255024233 |
| NPI Enumeration Date: | 02/02/2007 |
| NPI Last Update Date: | 10/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | LL00003248 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |