Provider Demographics
NPI:1710142377
Name:JOHNS, DONNA J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:J
Last Name:JOHNS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 NE 61ST ST
Mailing Address - Street 2:#202
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8753
Mailing Address - Country:US
Mailing Address - Phone:360-608-9311
Mailing Address - Fax:360-718-6554
Practice Address - Street 1:717 NE 61ST ST
Practice Address - Street 2:#202
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8753
Practice Address - Country:US
Practice Address - Phone:360-608-9311
Practice Address - Fax:360-718-6554
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60015408103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA125597OtherWASHINGTON STATE PROVIDER NUMBER