Yellow Brick Clinic PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

YELLOW BRICK CLINIC PLLC

Doing business as

Yellow Brick Clinic
Yellow Brick Clinic: ADHD, Autism, Developmental Behavioral Health

Practice address

DO Not Publish
Renton, WA 98056-2715

Phone

(425) 777-5467

Fax

(833) 631-6941

NPI assigned

Aug 2, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Kathleen Elizabeth Johnson, DNP, PMHNP, FNP,PMHSNPI 1871010306

Title

Nurse Practitioner

Phone

(425) 777-5467

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 2

• Yellow Brick Clinic Doing business as
• Yellow Brick Clinic: ADHD, Autism, Developmental Behavioral Health Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathleen Elizabeth Johnson, DNP, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lacey, WA
  • NPI 1871010306
  Medicare reassignment NPD Authorized official
• Mandie Rose Gardner, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Tumwater, WA
  • NPI 1205407376
  Medicare reassignment NPD
• Bianca Martinez Scanlon

  • Nurse Practitioner
  • Post Falls, ID
  • NPI 1548773575
  NPD
• Emily Schadt, ARNP

  • Pediatric Nurse Practitioner
  • Blue Grass, IA
  • NPI 1033551916

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1932687704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DO NOT PUBLISH",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980562715",
            "telephone_number": "425-736-9609",
            "fax_number": "833-631-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DO NOT PUBLISH",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980562715",
            "telephone_number": "425-777-5467",
            "fax_number": "833-631-6941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YELLOW BRICK CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-02",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "425-777-5467",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, PMHNP, FNP,PMHS"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60786815",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2090206",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yellow Brick Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Yellow Brick Clinic: ADHD, Autism, Developmental Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dylan Yango
• Natalie Yap, RPH
• Elie Yazdani
• Jamie M Yee, PA-C
• Samantha Nicole Yee, AAC
• Mony Yem
• Roy D Yen, MD
• In Ho Yeo
• Ana Raquel Yepes Pimentel
• Jennie Yeung, FNP-C

• Psychiatric/Mental Health Nurse Practitioner in Renton, WA
• Providers in Renton, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.