Individual provider Active NPI

David Lynn Johnson, RPH

  • Pharmacist
  • Bothell, WA
National Provider Identifier
1194908111
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00016291 Issued in WA
Practice address
21540 30TH Dr SE Ste 400
Bothell, WA 98021-7015
Phone
(425) 424-7140
NPI assigned
Dec 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00016291 WA Primary

Addresses

Primary practice location

21540 30TH Dr SE Ste 400
Bothell, WA 98021-7015

Mailing address

4 172ND PL SW
Bothell, WA 98012-9113
Phone (425) 745-2598

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH00016291WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1194908111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 172ND PL SW",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980129113",
            "telephone_number": "425-745-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21540 30TH DR SE STE 400",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980217015",
            "telephone_number": "425-424-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "LYNN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-13",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00016291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.