SUSAN JOHANNSEN (NPI# 1063026417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063026417 |
| Entity Type | Individual |
| Full Name | SUSAN JOHANNSEN |
| Credential | PSYD |
| Practice Address |
1717 13th St Everett WA 98201-1621 |
| Mailing Address |
13204 Ne 45th St Bellevue WA 98005-1135 |
| Practice Telephone | 4252975500 |
| Mailing Telephone | 4252818322 |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | MC61079678 | WA | Behavioral Health & Social Service Providers |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720080583 | Susan R Johannsen | Physician Assistant | 1200 S 7th Ave, Sioux Falls, SD 57105-0900 | 2005-08-11 |
| 1508852203 | Susan M Johannsen | Physician Assistant | 200 Hawkins Dr, University of Iowa Hospitals & Clinics, Iowa City, IA 52242-1009 | 2005-09-27 |
| Street Address |
1717 13TH ST |
| City | EVERETT |
| State | WA |
| Zip Code | 98201-1621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225037773 | Anna Sturm | Physician Assistant | 1717 13th St, Suite 401, Everett, WA 98201-1621 | 2005-07-18 |
| 1619575933 | The Everett Clinic, Pllc | Non-Pharmacy Dispensing Site | 1717 13th St, Everett, WA 98201-1621 | 2020-10-09 |
| 1023630803 | Grant Lovell | Radiologic Technologist | 1717 13th St, Everett, WA 98201-1621 | 2020-05-14 |
| 1093372344 | Dorothy Colleen Todd | Nurse Practitioner | 1717 13th St, Everett, WA 98201-1621 | 2019-05-22 |
| 1124584198 | Zaynah Ali | Pharmacist | 1717 13th St, Everett, WA 98201-1621 | 2019-02-14 |
| 1639650138 | Elizabeth M Poli | Nurse Practitioner | 1717 13th St, Everett, WA 98201-1621 | 2018-08-23 |
| 1770073975 | Connie Huyen Dao | Physician Assistant | 1717 13th St, Everett, WA 98201-1621 | 2018-05-14 |
| 1518482959 | Teri Kawehionalani Chiemi Schleicher | Pharmacist | 1717 13th St, Everett, WA 98201 | 2017-08-07 |
| 1861913519 | Paul Scott Hoffmann | Pharmacist | 1717 13th St, Everett, WA 98201 | 2017-07-03 |
| 1386199586 | Kristina Lee Campbell | Nurse Practitioner | 1717 13th St, Suite 401, Everett, WA 98201-1621 | 2016-08-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306471867 | Shannon Michelle Dewald | Registered Nurse | D8s 1700 13th St, Everett, WA 98201 | 2020-03-05 |
| 1578123113 | Precious Medicial Spa, LLC | Registered Nurse | 1728 W. Marine View Dr Suite 212, Everett, WA 98201 | 2019-06-17 |
| 1508429796 | Alix Deschain | Counselor | 2801 Broadway, Everett, WA 98201 | 2019-04-15 |
| 1811457534 | Khushboo Patel | Pharmacist | 1330 Rockefeller Ave Ste 150, Everett, WA 98201 | 2019-03-20 |
| 1164991188 | Grace Talbot Davis | Registered Nurse | 2601 Summit Avenue, Bldg. C, Everett, WA 98201 | 2018-11-20 |
| 1063924603 | Tracy Sisk | Counselor | 3120 Colby Ave, 502, Everett, WA 98201 | 2017-11-03 |
| 1710403126 | Michelle Durham | Counselor | 3322 Boadway Fl 2, Everett, WA 98201 | 2017-08-17 |
| 1861927949 | Melanie Schmidt | Counselor | 2610 Westmore Ave, Everett, WA 98201 | 2017-04-26 |
| 1518413327 | Joseph Madson Dmd Pllc | Clinic/Center | 3802 Colby Ave, 4th Floor, Everett, WA 98201 | 2016-08-31 |
| 1043683162 | Jennifer Adams | Counselor | 1511 26th St, Everett, WA 98201 | 2015-11-11 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437757556 | Christina Brown | Student in an Organized Health Care Education/Training Program | 4526 Federal Ave Ms# 11, Everett, WA 98203-2132 | 2020-10-12 |
| 1912525775 | Thanh Kim Huynh | Student in an Organized Health Care Education/Training Program | 12614 Alexander Rd, Everett, WA 98204-5429 | 2020-07-08 |
| 1417572009 | Megan Ostermick-durkee | Student in an Organized Health Care Education/Training Program | Sunrise Services Inc., 811 Madison Street, Everett, WA 98203 | 2020-06-10 |
| 1992326839 | Katie Ann Schmidt | Student in an Organized Health Care Education/Training Program | 915 N Broadway, Everett, WA 98201-1409 | 2020-05-01 |
| 1801442785 | Joseph Starzl | Student in an Organized Health Care Education/Training Program | 1202 Rucker Ave, Everett, WA 98201-1519 | 2019-08-15 |
| 1154985315 | Doan-trang Thi Kha | Student in an Organized Health Care Education/Training Program | 12624 11th Dr Se, Everett, WA 98208-6546 | 2019-04-23 |
| 1578126017 | Marianne Eugenia Kaufmann | Student in an Organized Health Care Education/Training Program | 2601 Summit Ave Bldg A, Everett, WA 98201-3309 | 2019-04-19 |
| 1760956841 | Zachary Daniel Hanson | Student in an Organized Health Care Education/Training Program | 2019 130th Pl Sw Unit F, Everett, WA 98204-6385 | 2019-01-11 |
| 1710472295 | Kristin Nichole Mccoy | Student in an Organized Health Care Education/Training Program | 111 Se Everett Mall Way Ste A-100, Everett, WA 98208-3208 | 2018-06-26 |
| 1639676232 | Nibras Lutfi Fakhri | Student in an Organized Health Care Education/Training Program | 1306 100th Pl Se Apt 4, Everett, WA 98208-4115 | 2018-04-10 |
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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.