Active NPI
Katherine Nan Johann, LMP
- Mechanotherapist
- Mountlake Terrace, WA
National Provider Identifier
1114136769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- MA00004822
- Practice address
- 22002 64TH Ave W
Suite M-3
Mountlake Terrace, WA 98043-2528 - Phone
- (425) 780-0399
- Fax
- (425) 672-3675
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | MA00004822 | WA | Primary |
Addresses
Primary practice location
22002 64TH Ave W
Suite M-3
Mountlake Terrace, WA 98043-2528
Mailing address
21604 66TH Ave W
Apartment a
Mountlake Terrace, WA 98043-2100
Phone (425) 780-0399
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA00004822 | WA | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114136769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21604 66TH AVE W",
"address_2": "APARTMENT A",
"city": "MOUNTLAKE TERRACE",
"state": "WA",
"postal_code": "980432100",
"telephone_number": "425-780-0399",
"fax_number": "425-672-3675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22002 64TH AVE W",
"address_2": "SUITE M-3",
"city": "MOUNTLAKE TERRACE",
"state": "WA",
"postal_code": "980432528",
"telephone_number": "425-780-0399",
"fax_number": "425-672-3675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHANN",
"first_name": "KATHERINE",
"middle_name": "NAN",
"name_prefix": "Mrs.",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "WA",
"license": "MA00004822",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountlake Terrace, WA
Sources for this page
- 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.