John Johnson, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP70001423 Issued in WA

Practice address

400 E Evergreen Blvd Ste 217
Vancouver, WA 98660-3264

Phone

(509) 596-1138

Fax

(971) 308-7811

NPI assigned

Oct 5, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Psychiatric and Sleep Medicine Associates, PLLCGroup PAC ID 4789901166, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premier Psychiatric & Sleep Medicine Associates, PLLC

  • Psychiatry Physician
  • Allen, TX
  • NPI 1992110886
  Medicare reassignment Care Compare group NPD
• Livewell

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
  • NPI 1922820489
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1003413808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W LAMBERTH RD STE A",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750922662",
            "telephone_number": "903-892-6700",
            "fax_number": "903-892-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E EVERGREEN BLVD STE 217",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986603264",
            "telephone_number": "509-596-1138",
            "fax_number": "971-308-7811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7820 NE Holman St Ste B7",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972182859",
            "country_code": "US",
            "telephone_number": "509-596-1138",
            "fax_number": "971-308-7811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "121 W Lamberth Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Sherman",
            "state": "TX",
            "postal_code": "750922662",
            "country_code": "US",
            "telephone_number": "903-892-6700",
            "fax_number": "903-892-6774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOHN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-05",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10046775",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP70001423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn Darrell Johnson
• Jamie Johnson, PSYD
• Jessica Johnson
• Jill A Johnson, LMP
• Jina Coleman Johnson
• Karen Marie Johnson, MA
• Katelyn Joy Johnson
• Kathlyn Marie Johnson, LMP
• Katie Rose Johnson, RN-BSN
• Kayla Lindsay Johnson

• Psychiatric/Mental Health Nurse Practitioner in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.