Provider Demographics
NPI:1376549337
Name:JOHNSTON, LINDA K (ARNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:K
Other - Last Name:ZEILENGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3002
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-0302
Mailing Address - Country:US
Mailing Address - Phone:360-414-2000
Mailing Address - Fax:
Practice Address - Street 1:1615 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2310
Practice Address - Country:US
Practice Address - Phone:360-414-2727
Practice Address - Fax:360-414-2739
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00054937163W00000X
WAAP30004941363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
500015680OtherRR MEDICARE
WA9623851Medicaid
WA9069JOOtherBLUE SHIELD
WA140112OtherLABOR & IND.
OR239007Medicaid
WA8926645OtherCRIME VICTIMS
WA8926645OtherCRIME VICTIMS
WA9069JOOtherBLUE SHIELD
OR239007Medicaid