Susan Ruth Johnson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10005035 Issued in WA

Practice address

91 SW Chehalis Ave Ste 101
Chehalis, WA 98532-1934

Phone

(360) 740-5181

Fax

(360) 740-6007

NPI assigned

Nov 22, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043385008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1883",
            "city": "YELM",
            "state": "WA",
            "postal_code": "985971883",
            "telephone_number": "360-894-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 SW CHEHALIS AVE STE 101",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985321934",
            "telephone_number": "360-740-5181",
            "fax_number": "360-740-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SUSAN",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10005035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L AND I",
            "identifier": "0215145",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Jean Johnson, RNC
• Julie Elizabeth Johnson, LMHC
• Louisa Viola Johnson, LMT
• Matthew Allen Johnson, PSY.D.
• Molly Johnson
• Eldon G Johnston, RPH
• Michele R Jones
• Sandra Jones, ESA CERTIFICATE
• Jennifer Joung, DMD
• Myung H Jung, OD

• Physician Assistant in Chehalis, WA
• Providers in Chehalis, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.