Erica K Johnson, PHD

Primary specialty

Rehabilitation PsychologistTaxonomy code 103TR0400X

License

PY60307202 Issued in WA

Practice address

19000 33Rd Ave W Ste 100
Lynnwood, WA 98036-4750

Phone

(425) 891-4480

Fax

(425) 629-9196

NPI assigned

Mar 30, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2017 through Jan 1, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1689069502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19000 33RD AVE W STE 100",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364750",
            "telephone_number": "425-891-4480",
            "fax_number": "425-629-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19000 33RD AVE W STE 100",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364750",
            "telephone_number": "425-891-4480",
            "fax_number": "425-629-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ERICA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WA",
            "license": "PY60307202",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "WA",
            "license": "PY60307202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael K Johansen, MS
• Susan Johansen, RN
• Kathy Thi Johnsen, PHARM.D
• Alexa Johnson, PTA
• Brittany Lynn Johnson, LMP
• Germaine Richard Johnson, MD
• Jarod Wyatt Johnson
• Jeanne Brabant Johnson, RN, BSN
• Joan Marie Johnson, MA LMHC
• Marina Rose Johnson, ND, LAC

• Rehabilitation Psychologist in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Rehabilitation Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.