Provider Demographics
NPI:1316210313
Name:JOHNSON, NAEEMAH EFURU-MUNIRAH (MSW)
Entity Type:Individual
Prefix:
First Name:NAEEMAH
Middle Name:EFURU-MUNIRAH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MONROE AVE NE
Mailing Address - Street 2:APT C-4
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-3903
Mailing Address - Country:US
Mailing Address - Phone:425-306-5245
Mailing Address - Fax:
Practice Address - Street 1:917 N CLEVELAND ST APT B
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1477
Practice Address - Country:US
Practice Address - Phone:509-366-7945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW601750421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical