Provider Demographics
NPI:1275771156
Name:JOHNSON, JAMILA LENEA (LMP)
Entity Type:Individual
Prefix:
First Name:JAMILA
Middle Name:LENEA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:JAMILA
Other - Middle Name:LENEA
Other - Last Name:APRIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 88574
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98138-2574
Mailing Address - Country:US
Mailing Address - Phone:253-951-1852
Mailing Address - Fax:253-850-4327
Practice Address - Street 1:351 STRANDER BLVD STE 8
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2916
Practice Address - Country:US
Practice Address - Phone:253-951-1852
Practice Address - Fax:253-850-4327
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60059546225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist