Provider Demographics
NPI:1134388655
Name:JOHNSON, ALLEN JAMES (ND)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:JAMES
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9023 11TH PL W
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-2694
Mailing Address - Country:US
Mailing Address - Phone:425-347-1740
Mailing Address - Fax:
Practice Address - Street 1:2106 N 45TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6902
Practice Address - Country:US
Practice Address - Phone:360-268-1603
Practice Address - Fax:360-268-1683
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000606175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath