Provider Demographics
NPI:1164905451
Name:JOHNS, BERNADETTE (PMHNP, ARNP)
Entity Type:Individual
Prefix:MS
First Name:BERNADETTE
Middle Name:
Last Name:JOHNS
Suffix:
Gender:F
Credentials:PMHNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 LILLY RD NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5115
Mailing Address - Country:US
Mailing Address - Phone:360-923-7000
Mailing Address - Fax:
Practice Address - Street 1:5486 HARBOR AVE
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:WA
Practice Address - Zip Code:98249-3002
Practice Address - Country:US
Practice Address - Phone:360-331-5060
Practice Address - Fax:360-331-2104
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60849404363L00000X, 363LP0808X
CA95008887363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily