Individual provider Active NPI

Denise Dianne Johnson, RPH

  • Pharmacotherapy Pharmacist
  • Mount Vernon, WA
National Provider Identifier
1265724256
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
PH16572 Issued in WA
Practice address
307 S 13TH St
Suite 100
Mount Vernon, WA 98274-4100
Phone
(360) 424-2684
Fax
(360) 424-2645
NPI assigned
May 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X PH16572 WA Primary

Addresses

Primary practice location

307 S 13TH St
Suite 100
Mount Vernon, WA 98274-4100

Mailing address

307 S 13TH St
Suite 100
Mount Vernon, WA 98274-4100
Phone (360) 424-2684

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
PH16572WAMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304899200000",
    "number": "1265724256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S 13TH ST",
            "address_2": "SUITE 100",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744100",
            "telephone_number": "360-424-2684",
            "fax_number": "360-424-2645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S 13TH ST",
            "address_2": "SUITE 100",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744100",
            "telephone_number": "360-424-2684",
            "fax_number": "360-424-2645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DENISE",
        "middle_name": "DIANNE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-09",
        "last_updated": "2011-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "WA",
            "license": "PH16572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; 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.