MR. CLYDE W JOHNSON (NPI# 1962579375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962579375 |
Entity Type | Individual |
Full Name | MR. CLYDE W JOHNSON |
Credential | PT, CHT |
Practice Address |
1200 112th Ave Ne Ste C260 Bellevue WA 98004 |
Mailing Address |
510 8th Ave Ne Ste 320 Issaquah WA 98029-5436 |
Practice Telephone | 4254625006 |
Practice Fax Number | 4254625019 |
Mailing Telephone | 4254625006 |
Mailing Fax Number | 4254625019 |
Enumeration Date | 2006-11-29 |
Last Update Date | 2019-09-12 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 225100000X | Physical Therapist | PT00005729 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Y | 2251H1200X |
Physical Therapist Specialization: Hand |
PT00005729 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | 1023366 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
1632 116th Ave Ne, Suite C, Bellevue, WA 980043035 | 4254629800 | 4254549143 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821256223 | Clyde D Johnson Jr. | Physician Assistant | 5881 Glendrige Dr Ne, Suite 120, Atlanta, GA 30328 | 2008-06-02 |
1447749056 | Clyde Johnson IIi | Community/Behavioral Health | 2525 Tiller Lane Ste 110, Columbus, OH 43231 | 2018-05-09 |
1063766723 | Clyde Francis Johnson | Chiropractor | 7940 S University Blvd, Ste 100, Centennial, CO 80122-5104 | 2012-11-02 |
1568767317 | Clyde Johnson | Counselor | 930 N 14th St, New Castle, IN 47362-4311 | 2011-01-25 |
1124007851 | Clyde L. Johnson Jr. | Surgery | 1051 Johnston Willis Dr., St. 200, Richmond, VA 23235 | 2006-01-11 |
Street Address |
1200 112TH AVE NE STE C260 |
City | BELLEVUE |
State | WA |
Zip Code | 98004 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275593014 | Lorelei A Mock | Physical Therapist | 1200 112th Ave Ne Ste C260, Bellevue, WA 98004 | 2006-03-24 |
1861090292 | Nelson Thai | Physical Therapist | 1200 112th Ave Ne Ste C260, Bellevue, WA 98004-3746 | 2020-10-16 |
1154929537 | Jennifer Louise Davis | Physical Therapist | 1200 112th Ave Ne Ste C260, Bellevue, WA 98004-3746 | 2020-10-16 |
1508393133 | Rachel Lauren Entrekin | Physical Therapist | 1200 112th Ave Ne Ste C260, Bellevue, WA 98004-3746 | 2017-05-14 |
1598151870 | Nicole Victoria Jimenez | Physical Therapist | 1200 112th Ave Ne Ste C260, Bellevue, WA 98004 | 2015-04-13 |
1477726446 | Megan Noel Swanson | Occupational Therapist | 1200 112th Ave Ne Ste C260, Bellevue, WA 98004-3746 | 2008-04-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
1720553613 | Christine Eyler | Pediatrics | Bellevue Pediatrics, C & C Medical Associates, 1940 116th Ave Ne, Ste 200, Bellevue, WA 98004 | 2018-10-08 |
1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
1669989216 | Atsuko Nakajima | Acupuncturist | 2223 112th Ave. Ne, Ste 201, Bellevue, WA 98004 | 2018-01-04 |
1740794718 | Radka Chapin Counseling, LLC | Clinic/Center | 1611 116th Ave Ne Ste 119, Bellevue, WA 98004 | 2017-11-28 |
1962912105 | Cuyler Ann Simmons | Counselor | 3805 108th Ave Ne Ste 204, Bellevue, WA 98004 | 2017-10-02 |
1639690357 | Nicolas Lopez-montalvo | Behavioral Analyst | 3003 Northup Way Suite 200, Bellevue, WA 98004 | 2017-07-03 |
1124579537 | Matthew Thomas Haley | Pharmacist | 107 Bellevue Way, Se, Bellevue, WA 98004 | 2016-10-20 |
1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
Find all providers in zip 98004 |
Taxonomy Code | 2251H1200X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Physical Therapist |
Specialization | Hand |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083112254 | Therapy Management Services, Pllc | Physical Therapist | 19400 108th Ave Se Ste 100, Kent, WA 98031-0108 | 2018-01-23 |
1346589512 | Karen Hull Lauckhardt | Physical Therapist | 420 S Clarkwood Dr, Bellingham, WA 98225-8702 | 2013-02-07 |
1265659387 | Totem Lake Physical Therapy, Pllc | Physical Therapist | 12910 Totem Lake Blvd, Suite 105, Kirkland, WA 98034 | 2007-04-19 |
1164580809 | Hand Therapy Northwest Inc | Physical Therapist | 16150 Ne 85th Street, Suite 116, Redmond, WA 98052 | 2006-12-05 |
1154302081 | Michael James Poulos | Physical Therapist | 1611 Broadway, Bellingham, WA 98225-3039 | 2005-11-08 |
1639219868 | Bainbridge Island Physical Therapy, LLC | Physical Therapist | 563 Madison Ave N, Bainbridge Island, WA 98110-1768 | 2007-02-07 |
1124003223 | Phillip A Ruff | Physical Therapist | 200 Ne Mother Joseph Pl, Suite 110, Vancouver, WA 98664-3299 | 2005-12-12 |
1285615625 | Deborah M Howard | Physical Therapist | 600 Broadway, Ste 440, Seattle, WA 98122 | 2005-11-11 |
Please comment or provide details below to improve the information on MR. CLYDE W JOHNSON.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.