| Organization Name: | KATHRYN L DRAKE JOHANSEN ARNP, PLLC |
| NPI Number: | 1336576396 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KATHRYN LEILA DRAKE JOHANSEN (PMHNP) |
| Mailing Address: | 920 Alder Ave Suite 203 Sumner |
| State: | WA US |
| Postal Code: | 983901401 |
| Phone Number: | 2538260157 |
| Fax Number: | 2538639415 |
| NPI Enumeration Date: | 10/04/2013 |
| NPI Last Update Date: | 10/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | AP30007575 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |