Individual provider Active NPI

Sarah Elizabeth Johnston, M.S.

  • Speech-Language Pathologist
  • Lakewood, WA
National Provider Identifier
1194291716
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SI60921539 Issued in WA
Practice address
8909 Gravelly Lake Dr SW Ste D
Lakewood, WA 98499-3101
Phone
(253) 753-4008
NPI assigned
Oct 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SI60921539 WA Primary

Addresses

Primary practice location

8909 Gravelly Lake Dr SW Ste D
Lakewood, WA 98499-3101

Mailing address

8909 Gravelly Lake Dr SW Ste D
Lakewood, WA 98499-3101
Phone (253) 753-4008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200605001624 WA Practitioner - Qualified Speech Language Pathologist 2567883192

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SI60921539WAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
MMG Speech & Therapeutic Services, LLC Speech-Language Pathologist CurrentSince Jun 15, 2020 Accepting new patients

Locations

9881 Bridgeport Way SW
Lakewood, WA 98499
Phone (253) 753-4008

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1194291716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8909 GRAVELLY LAKE DR SW STE D",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993101",
            "telephone_number": "253-753-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8909 GRAVELLY LAKE DR SW STE D",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993101",
            "telephone_number": "253-753-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "SI60921539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.