Individual provider Active NPI

Erin Dawn Johnson, M.S.P.A./CCC-SLP

  • Speech-Language Pathologist
  • Bothell, WA
National Provider Identifier
1730425109
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL00001308 Issued in WA
Practice address
23400 5TH Ave W
Bothell, WA 98021-8529
Phone
(425) 408-5260
Fax
(425) 408-5202
NPI assigned
Dec 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X LL00001308 WA Primary

Addresses

Primary practice location

23400 5TH Ave W
Bothell, WA 98021-8529

Mailing address

3330 Monte Villa Pkwy
Bothell, WA 98021-8972
Phone (425) 408-6021

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
LL00001308WAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1355270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1730425109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 MONTE VILLA PKWY",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980218972",
            "telephone_number": "425-408-6021",
            "fax_number": "425-408-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23400 5TH AVE W",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980218529",
            "telephone_number": "425-408-5260",
            "fax_number": "425-408-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ERIN",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "M.S.P.A./CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-12",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00001308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.