Individual provider Active NPI

Deborah Jean Johnson, RNC

  • Child & Adolescent Psychiatric/Mental Health Registered Nurse
  • Chehalis, WA
National Provider Identifier
1679604052
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X
License
RN00114439 Issued in WA
Practice address
135 W Main St
Chehalis, WA 98532-4817
Phone
(360) 748-6696
Fax
(360) 748-0627
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X RN00114439 WA Primary

Addresses

Primary practice location

135 W Main St
Chehalis, WA 98532-4817

Mailing address

PO Box 1445
Chehalis, WA 98532-0378
Phone (360) 748-6696

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
RN00114439WAMDChild & Adolescent Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679604052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1445",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320378",
            "telephone_number": "360-748-6696",
            "fax_number": "360-748-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W MAIN ST",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985324817",
            "telephone_number": "360-748-6696",
            "fax_number": "360-748-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEBORAH",
        "middle_name": "JEAN",
        "credential": "RNC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "WA",
            "license": "RN00114439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.