Doctor Name: | KRISTINA JOHNSTON |
NPI Number: | 1184073348 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SI60663900 |
Business Practice Address: | 3600 Lind Ave Sw Ste 160 Renton, WA - 980574934 |
Business Phone Number: | 4256564215 |
Business Fax Number: | 4256565075 |
Mailing Address: | 3600 Lind Ave Sw, Ste 160 RENTON |
State: | WA |
Postal Code: | 980574934 |
Phone Number: | 4256564215 |
Fax Number: | 4256565075 |
NPI Enumeration Date: | 06/08/2016 |
NPI Last Update Date: | 06/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | SI60663900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |