Glenn Darrell Johnson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

12607 SE Mill Plain Blvd
Vancouver, WA 98684-6055

Phone

(360) 859-6491

Fax

(360) 896-4478

NPI assigned

Jun 11, 2025

Last updated

Jun 17, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1749600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1952296675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322099",
            "telephone_number": "360-718-0173",
            "fax_number": "360-896-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12607 SE MILL PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846055",
            "telephone_number": "360-859-6491",
            "fax_number": "360-896-4478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 NE Multnomah St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972322099",
            "country_code": "US",
            "telephone_number": "360-718-0173",
            "fax_number": "360-896-4478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GLENN",
        "middle_name": "DARRELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-11",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Isaac Johnson, D.C.
• Deanna Victoria Johnson, LMP
• Debra Faith Johnson
• Dexter E Johnson
• Douglas R Johnson, DO
• Jamie Johnson, PSYD
• Jessica Johnson
• Jill A Johnson, LMP
• Jina Coleman Johnson
• John Johnson, NURSE PRACTITIONER

• Addiction (Substance Use Disorder) Counselor in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.