| Doctor Name: | ALICIA KATHERINE JOHNSON |
| NPI Number: | 1225298797 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMP, |
| License Number: | MA00024163 |
| Business Practice Address: | 1207 Se Rasmussen Blvd Ste 111 Battle Ground, WA - 986048618 |
| Business Phone Number: | 3606077368 |
| Business Fax Number: | |
| Mailing Address: | 1207 Se Rasmussen Blvd Ste 111, BATTLE GROUND |
| State: | WA |
| Postal Code: | 986048618 |
| Phone Number: | 3606077368 |
| Fax Number: | |
| NPI Enumeration Date: | 06/09/2008 |
| NPI Last Update Date: | 05/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 305S00000X |
| License Number: | MA00024163 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Point of Service |
| Taxonomy Specialization: | |
| Taxonomy Definition: | This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |