KELLY JOHNSON (NPI# 1720408172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720408172 |
| Entity Type | Individual |
| Full Name | KELLY JOHNSON |
| Practice Address |
301 S 320th St Federal Way WA 98003-5200 |
| Practice Telephone | 2538747000 |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2015-11-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 60610430 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023631249 | Kelly Lynn Johnson | Occupational Therapist | 22123 Figueroa St Unit 113, Carson, CA 90745-4464 | 2020-05-21 |
| 1851932404 | Kelly Christine Johnson | Nurse Practitioner | 7319 Stonerock Cir # 106, Orlando, FL 32819-8002 | 2019-10-04 |
| 1083274989 | Kelly Danielle Johnson | Registered Nurse | 76 Dubois Ct Apt D, Englewood, NJ 07631-3439 | 2019-06-13 |
| 1871151365 | Kelly Johnson | Family Medicine | 103 S White Oak Rd, White Oak, TX 75693-1517 | 2019-05-30 |
| 1194288753 | Kelly Mills Johnson | Psychologist | 100 Bush St Ste 918, San Francisco, CA 94104-3950 | 2019-04-10 |
| 1700345345 | Kelly Marlene Johnson | Nurse Practitioner | 1320 E Oklahoma Ave, Guthrie, OK 73044-3757 | 2019-03-13 |
| 1891253597 | Kelly Marie Johnson | Specialist/Technologist | 1472 Mobley Ct, Frederick, MD 21701-9113 | 2019-03-12 |
| 1447744347 | Kelly Theresa Johnson | Speech-Language Pathologist | 5272 River Rd Ste 100, Bethesda, MD 20816-1454 | 2018-06-14 |
| 1962902882 | Kelly M Johnson | Licensed Vocational Nurse | 118 Brazos Ln, Kyle, TX 78640-5289 | 2018-02-16 |
| 1427573476 | Kelly Colleen Johnson | Social Worker | 2530 Meridian Parkway, Suite 300, Pbn: 3071, Durham, NC 27713-2771 | 2017-08-11 |
| Street Address |
301 S 320TH ST |
| City | FEDERAL WAY |
| State | WA |
| Zip Code | 98003-5200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699764472 | Tina M. Hawley | Family Medicine | 301 S 320th St, Federal Way, WA 98003-5200 | 2005-10-14 |
| 1578020707 | Edith S Chan | Social Worker | 301 S 320th St, Federal Way, WA 98003-5200 | 2019-02-24 |
| 1902335292 | Diana Suwah Trinh | Physician Assistant | 301 S 320th St, Federal Way, WA 98003-5200 | 2017-06-08 |
| 1891101531 | Lateef Johnson Harper | Family Medicine | 301 S 320th St, Federal Way, WA 98003-5200 | 2014-07-02 |
| 1588091730 | Amy Marie Coppeans | Nurse Practitioner | 301 S 320th St, Federal Way, WA 98003-5200 | 2013-10-02 |
| 1740523794 | Derek Lin | Internal Medicine | 301 S 320th St, Federal Way, WA 98003-5200 | 2013-03-28 |
| 1588911978 | Kathryn Dunphy Lent | Physical Therapist | 301 S 320th St, Federal Way, WA 98003-5200 | 2012-08-06 |
| 1780968883 | Elizabeth Kathleen Shuckhart | Physician Assistant | 301 S 320th St, Federal Way, WA 98003-5200 | 2011-10-06 |
| 1215228283 | Kaiser Foundation Health Plan of Washington | Clinic/Center | 301 S 320th St, Federal Way, WA 98003-5200 | 2011-04-26 |
| 1154659795 | Tyler Richard Chisholm | Family Medicine | 301 S 320th St, Federal Way, WA 98003-5200 | 2009-11-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634969 | Jossie Jeniffer Wong-vicuna | Interpreter | 3001 S 288th Street, 201, Ferderal Way, WA 98003 | 2020-09-17 |
| 1336642420 | Otto Family | Massage Therapist | 720 S 348th St Ste A-1b, Federal Way, WA 98003 | 2018-03-14 |
| 1962912709 | Lindsay Plumley | Occupational Therapist | 33330 8th Avenue S, Federal Way, WA 98003 | 2017-10-06 |
| 1861922387 | Sea Mar Community Health Centers | Pharmacy | 31405 18th Ave South, Federal Way, WA 98003 | 2017-06-18 |
| 1023547072 | Iora Health Washington Physicians, P.C. | Internal Medicine | 1414 S. 324th Street, Federal Way, WA 98003 | 2017-06-05 |
| 1811346869 | Iora Senior Health Inc | Internal Medicine | 1414 S 324th St, Federal Way, WA 98003 | 2016-06-10 |
| 1972958940 | Kathy Marie Haviland | Registered Nurse | 1010 S. 336th St, Supplemental Health Care, Federal Way, WA 98003 | 2016-04-27 |
| 1972969343 | Jacklyn Marie James | Specialist | 530 South 336th Street, Ste C, Massage for Health and Day Spa, Inc., Federal Way, WA 98003 | 2016-01-14 |
| 1659767036 | Jillian Liner | Pediatrics | 34503 9th Ave S Ste 220, Federal Way, WA 98003 | 2015-04-12 |
| 1235537739 | Simranjit Singh Longia | Student in an Organized Health Care Education/Training Program | 34618 11th Ave. S., Suite 100, Federal Way, WA 98003 | 2014-12-15 |
| Find all providers in zip 98003 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700309416 | Jennifer Lynn Cha | Physician Assistant | 820 Sw 341st St., Federal Way, WA 98023 | 2017-07-25 |
| 1265985972 | Destiny Voelpel | Physician Assistant | 34509 9th Ave S Ste 304, Federal Way, WA 98003-8709 | 2016-07-28 |
| 1629474135 | Sossan Jamilah Johnston | Physician Assistant | 109 Sw 366th St, Federal Way, WA 98023-7372 | 2014-11-10 |
| 1295137719 | Nicholas Dale Francis | Physician Assistant | 31829 3rd Pl Sw, 13d, Federal Way, WA 98023-4839 | 2014-09-16 |
| 1710240841 | Seattle Pain Relief Pllc | Physician Assistant | 35002 Pacific Hwy S, Ste A105, Federal Way, WA 98003-8365 | 2012-06-22 |
| 1679897235 | Chavela Briones Stokes | Physician Assistant | 35002 Pacific Hwy S Ste A105, Federal Way, WA 98003-8366 | 2010-03-24 |
| 1154571263 | Erin Lisa Mcilrath | Physician Assistant | 34515 9th Ave S., St. Francis Hospital, Federal Way, WA 98003 | 2008-09-25 |
| 1265477129 | Kevin R Lafave | Physician Assistant | 34519 9th Ave S, Federal Way, WA 98003-6761 | 2006-06-17 |
| 1952951030 | Colleen Marie Davies | Physician Assistant | 34716 1st Ave S, Federal Way, WA 98003-6760 | 2019-09-19 |
| 1982175527 | Nathan Harding | Physician Assistant | 34515 9th Ave S, Federal Way, WA 98003-6761 | 2018-12-07 |
| Find all providers in FEDERAL WAY | ||||
| City | FEDERAL WAY |
| Zip Code | 98003 |
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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.