David Johnson
Individual provider Active NPI Massage Therapist · Vancouver, WA
NPI 1366848731 · NPPES record last updated Nov 13, 2014
Key facts
- NPI
- 1366848731
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA 00022224 (WA)
- Practice address
- 1319 NE 134TH St Ste 103
Vancouver, WA 98685-2718 - Phone
- (360) 574-3141
- NPI assigned
- Nov 13, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA 00022224 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cke Longevity LLC | Massage Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA 00022224 | WA | Yes |
Addresses
Primary practice location
1319 NE 134TH St Ste 103
Vancouver, WA 98685-2718
Mailing address
1319 NE 134TH St Suite 103
Vancouver, WA 98685
Phone (360) 574-3141
Other providers in Vancouver, WA
- Christopher Kirk Johnson
- Clara Marie Johnson
- Dalonia Darneace Johnson
- Danna Lori Johnson
- David Johnson
- David Alan Johnson
- David Isaac Johnson
- Deanna Victoria Johnson
- Debra Faith Johnson
- Dexter E Johnson
All providers in Vancouver, WA · Massage Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.