Kaj Johansen, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

MD00016486 Issued in WA

Practice address

600 Broadway Ste 112
Seattle, WA 98122-5381

Phone

(206) 420-3119

Fax

(206) 453-5912

NPI assigned

May 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Radia Inc P S

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1932196607
  NPD (past)

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1366491045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22152",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981220152",
            "telephone_number": "206-420-3119",
            "fax_number": "206-453-5912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BROADWAY STE 112",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225381",
            "telephone_number": "206-420-3119",
            "fax_number": "206-453-5912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "574 N 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Sequim",
            "state": "WA",
            "postal_code": "983823079",
            "country_code": "US",
            "telephone_number": "206-420-3119",
            "fax_number": "206-453-5912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "KAJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WA",
            "license": "MD00016486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8400103",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johanna Richter Nutrition Wellness LLC
• Johanna Richter Nutrition Wellness LLC
• Keith William Johannes, MSW
• Kristin Ann Johannsen, DDS, MSD
• Tracy A. Johannsen, MD
• Sheila Johansen, ARNP
• Margaret Johanson, RN BSN
• Steve Michael Johanson
• John B Thomas
• John B. Cardinali, Psy.D., PS

• Vascular Surgery Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Vascular Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.