Provider Demographics
NPI:1124230024
Name:JOHNSTON, EMILY E (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:E
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62114 WILLOW TREE WAY E
Mailing Address - Street 2:
Mailing Address - City:GREENWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98022-8075
Mailing Address - Country:US
Mailing Address - Phone:206-200-9497
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-8642
Practice Address - Country:US
Practice Address - Phone:253-968-3884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1679207P00000X
WA60170963207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine