Sara Eileen Johnson

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

61375693 Issued in WA

Practice address

633 E Pioneer Ave
Montesano, WA 98563-4700

Phone

(800) 781-5536

NPI assigned

May 2, 2023

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

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": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1093404402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 W MARCY AVE",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985633419",
            "telephone_number": "253-381-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 E PIONEER AVE",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985634700",
            "telephone_number": "800-781-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SARA",
        "middle_name": "EILEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "61375693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Ann Jackson, PT, DPT
• Grant Wells Jackson, MD
• Stephanie Janssen, LMHCA
• Brooke Mercedes Joaquin
• Mikaila Ann Johnson, OTR
• Bessie Jones
• Alethea Marie Keith-Pyhala, LMHC, CMHS
• Larry Neil Kelly, D.C.
• KGP LLC (Kerry Peterson FNP)
• Marina Kuran, LMHC

• Behavior Technician in Montesano, WA
• Providers in Montesano, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; 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.