Provider Demographics
NPI:1841220183
Name:JOHNSTON-KITAZAWA, MARGARET (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:
Last Name:JOHNSTON-KITAZAWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:KITAZAWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 490
Mailing Address - Street 2:
Mailing Address - City:PAHALA
Mailing Address - State:HI
Mailing Address - Zip Code:96777-0490
Mailing Address - Country:US
Mailing Address - Phone:808-895-1153
Mailing Address - Fax:
Practice Address - Street 1:2209 E 32ND ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98404-4922
Practice Address - Country:US
Practice Address - Phone:253-593-0232
Practice Address - Fax:253-382-2091
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00019271207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0182526OtherLABOR & INDUSTRIES
WA8185407Medicaid
WA1447JOOtherREGENCE
WA0182526OtherLABOR & INDUSTRIES
WA1447JOOtherREGENCE