PHYLLIS C JOHNSEN P.A. NPI 1578607412

NPI Information

NPI: 1578607412
Provider Name: PHYLLIS C JOHNSEN, P.A.
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
209 MARTIN LUTHER KING JR WAY
TACOMA, WA
ZIP 98405
Phone: (253) 596-3300
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Phyllis C Johnsen, P.A. is a medical physician assistant in Tacoma, WA. Phyllis C Johnsen, P.A. NPI is 1578607412. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

209 MARTIN LUTHER KING JR WAY
TACOMA, WA
ZIP 98405-265
Phone: (253) 596-3300

The enumeration date for this NPI number is 2/16/2007 and was last updated on 4/1/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA10001989	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	G8878427	MEDICARE PIN	WASHINGTON
2	G8872394	MEDICARE PIN	WASHINGTON
3	P09130	MEDICARE UPIN	WASHINGTON
4	G8857515	MEDICARE PIN	WASHINGTON
5	G8878426	MEDICARE PIN	WASHINGTON
6	GAB16061	MEDICARE PIN	WASHINGTON
7	G8857514	MEDICARE PIN	WASHINGTON
8	8357071	MEDICAID	WASHINGTON
9	G8857517	MEDICARE PIN	WASHINGTON
10	G8857516	MEDICARE PIN	WASHINGTON
11	G8857513	MEDICARE PIN	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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