Mallory Marie Johnson, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60119122 Issued in WA

Practice address

670 NW Gilman Blvd
Suite #B2
Issaquah, WA 98027-2444

Phone

(425) 427-6562

NPI assigned

Dec 17, 2009

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1992034144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13031 123RD LN NE",
            "address_2": "D202",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347344",
            "telephone_number": "206-714-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 NW GILMAN BLVD",
            "address_2": "SUITE #B2",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272444",
            "telephone_number": "425-427-6562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MALLORY",
        "middle_name": "MARIE",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-17",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60119122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia John Vega
• Danielle Katherine Johnson
• Emily Claire Johnson
• Jennifer Johnson, MA, LMHCA
• Kyleigh Johnson, OD
• Mary-Elizabeth Johnson
• Melinda Brooke Johnson, MA, LMFT, PMH-C
• Paula B Johnson, MS, LMHC
• Tiffany Charlene Johnson, CNM, ARNP
• Craig Peter Johnston, D.D.S.

• Massage Therapist in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; 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.