DR. KELVIE A JOHNSON (NPI# 1023019858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023019858 |
| Entity Type | Individual |
| Full Name | DR. KELVIE A JOHNSON |
| Credential | M.D. |
| Practice Address |
525 Lilly Rd Ne Olympia WA 98506-5101 |
| Practice Telephone | 3604937230 |
| Practice Fax Number | 3604934180 |
| Mailing Telephone | 3604937230 |
| Mailing Fax Number | 3604934180 |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2007-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0000X |
Family Medicine Specialization: Adolescent Medicine |
MD00025100 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8303489 | 05 |
| Street Address |
525 LILLY RD NE |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98506-5101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861493884 | Suzanne Ellen Woodsum-reed | Social Worker | 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 2005-08-02 |
| 1730702432 | Chanel Wood | Student in an Organized Health Care Education/Training Program | 525 Lilly Rd Ne, Suite 204, Olympia, WA 98506 | 2020-05-28 |
| 1982227062 | Jairo Enrigue Mendoza Briceno | Student in an Organized Health Care Education/Training Program | 525 Lilly Rd Ne, Suite 204, Olympia, WA 98506-5101 | 2020-05-22 |
| 1598384901 | Junun Bae | Student in an Organized Health Care Education/Training Program | 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 2020-04-15 |
| 1205484813 | Neighborcare Health | Clinic/Center | 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 2019-08-27 |
| 1972158210 | Erik Gilbert Gunderson | Pharmacist | 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 2019-08-05 |
| 1215595509 | Hieu Thi Minh Duong | Family Medicine | 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 2019-05-31 |
| 1255998324 | Fang-yu Lee | Family Medicine | 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 2019-05-23 |
| 1588221642 | Jennifer Jean Goodrich | Family Medicine | 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 2019-05-23 |
| 1831756998 | Ryan Edel Kuhar | Family Medicine | 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 2019-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
| 1912543539 | Jessica Marie Radakovich | Licensed Practical Nurse | 3426 Mary Elder Rd, Olympia, WA 98506 | 2019-11-19 |
| 1669014973 | Arlene Josephine Adams | Registered Nurse | 413 Lily Rd Ne, Olympia, WA 98506 | 2019-10-09 |
| 1861999120 | Debra Delores Barker | Licensed Practical Nurse | 3710 South Bay Rd Ne, Olympia, WA 98506 | 2018-04-12 |
| 1801304431 | Michelle Warner | Nurse Practitioner | 205 Lilly Rd Ne Ste A1, Olympia, WA 98506 | 2018-01-17 |
| 1396258364 | Institute for Family Development | Community/Behavioral Health | 204 Quince St. Ne, Suite 200, Olympia, WA 98506 | 2017-11-13 |
| 1083137715 | Cameron Kunkel | Specialist/Technologist | 2512 20th Ave Ne, Olympia, WA 98506 | 2017-07-25 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
| 1780114371 | Priscilla Kangyang Jadu | Counselor | 3857 Martin Way E., Olympia, WA 98506 | 2017-06-15 |
| Find all providers in zip 98506 | ||||
| Taxonomy Code | 207QA0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adolescent Medicine |
| A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265502751 | James Henry States II | Family Medicine | 561 N Tribal Center Rd, Skokomish Nation, WA 98584-7416 | 2006-11-09 |
| 1487056511 | Tenino Family Practice Pllc | Family Medicine | 273 Sussex Ave E, Tenino, WA 98589-9359 | 2014-09-19 |
| 1659553741 | Dennis Edward Morrisroe | Family Medicine | 100 E 33rd St Ste 206, Hudson's By Medical Group Inc Ps, Vancouver, WA 98663 | 2007-11-29 |
| 1891849485 | Kathleen G. Thomas | Family Medicine | 1400 Pottery Ave, Port Orchard, WA 98366-3711 | 2007-01-22 |
| 1376691824 | Nila Jones | Family Medicine | 7410 Delaware Ln, Vancouver, WA 98664-1408 | 2007-01-08 |
| 1639271489 | Elizabeth Campbell | Family Medicine | 403 E Meeker St, Suite 300, Kent, WA 98030-5904 | 2006-09-02 |
| 1316056096 | Skokomish Tribal Council | Family Medicine | 100 N Tribal Center Rd, Skokomish Nation, WA 98584-9748 | 2006-08-29 |
| 1972527141 | Geoffrey Macpherson | Family Medicine | 6920 Coal Creek Pkwy Se, Ste 12, Newcastle, WA 98059-3147 | 2006-07-27 |
| 1871514018 | Kari Palmer | Family Medicine | 509 Olive Way, Suite 900, Seattle, WA 98101-1720 | 2006-07-22 |
| 1265468631 | Margaret Mamolen | Family Medicine | 516 High St, Western Washington University, Bellingham, WA 98225-5946 | 2006-06-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.