Active NPI
Kewn Johnson
- Physical Therapy Assistant
- North Bend, WA
National Provider Identifier
1417190802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PI 60031545
- Practice address
- 219 Cedar Ave S
North Bend, WA 98045-8262 - Phone
- (425) 888-2129
- NPI assigned
- Apr 14, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PI 60031545 | WA | Primary |
Addresses
Primary practice location
219 Cedar Ave S
North Bend, WA 98045-8262
Mailing address
PO Box 591
Issaquah, WA 98027-0022
Phone (425) 888-0670
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PI 60031545 | WA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239667200000",
"number": "1417190802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 591",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980270022",
"telephone_number": "425-888-0670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "219 CEDAR AVE S",
"city": "NORTH BEND",
"state": "WA",
"postal_code": "980458262",
"telephone_number": "425-888-2129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KEWN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-14",
"last_updated": "2009-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WA",
"license": "PI 60031545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Bend, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.