Individual provider Active NPI

Thomas Richard Johnson

  • Counselor
  • Port Angeles, WA
National Provider Identifier
1073462370
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CO61645104 Issued in WA
Practice address
825 E 5TH St
Port Angeles, WA 98362-3818
Phone
(360) 351-4304
NPI assigned
Jan 28, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CO61645104 WA Primary

Addresses

Primary practice location

825 E 5TH St
Port Angeles, WA 98362-3818

Mailing address

15404 E Springfield Ave
Spokane Valley, WA 99037-8569
Phone (360) 351-4304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CO61645104WAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Abhs Port Angeles Outpatient Program PastSince Jan 4, 2026 Accepting new patients
Abhs Spokane Outpatient Program PastSince Dec 7, 2025 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1769558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1073462370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15404 E SPRINGFIELD AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990378569",
            "telephone_number": "360-351-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E 5TH ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623818",
            "telephone_number": "360-351-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "THOMAS",
        "middle_name": "RICHARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-28",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CO61645104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; 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.