Provider Demographics
NPI:1033465182
Name:JOHNS, ADAM ROBINSON (MA)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:ROBINSON
Last Name:JOHNS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12025 115TH AVE NE
Mailing Address - Street 2:BUILDING D, STE 200
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-6942
Mailing Address - Country:US
Mailing Address - Phone:425-821-1810
Mailing Address - Fax:
Practice Address - Street 1:12025 115TH AVE NE
Practice Address - Street 2:BUILDING D, STE 200
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-6942
Practice Address - Country:US
Practice Address - Phone:425-821-1810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-26
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60633833106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist