Individual provider Active NPI

Andreanna Elisabeth Johnson

  • Counselor
  • Spokane, WA
National Provider Identifier
1497186043
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CG61130270 Issued in WA
Practice address
210 W Sprague Ave
Spokane, WA 99201-3627
Phone
(509) 747-8224
Fax
(509) 747-0609
NPI assigned
Dec 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60421023 WA
Counselor 101Y00000X CG61130270 WA Primary

Addresses

Primary practice location

210 W Sprague Ave
Spokane, WA 99201-3627

Mailing address

210 W Sprague Ave
Spokane, WA 99201-3627
Phone (509) 747-8224

Other practice location 1

10709 N Division
Spokane, WA 99218
Phone (509) 466-9008

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

LicenseStateTypeSpecialty
CG61130270WAMDCounselor
MA60421023WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1497186043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W SPRAGUE AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992013627",
            "telephone_number": "509-747-8224",
            "fax_number": "509-747-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W SPRAGUE AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992013627",
            "telephone_number": "509-747-8224",
            "fax_number": "509-747-0609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10709 N Division",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "99218",
            "country_code": "US",
            "telephone_number": "509-466-9008",
            "fax_number": "509-466-0175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDREANNA",
        "middle_name": "ELISABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-09",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60421023",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG61130270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; 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.