Provider Demographics
NPI:1154956720
Name:JOHNSON, ARLENE (DNP, CNM, ARNP)
Entity type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DNP, CNM, ARNP
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:
Other - Last Name:AMADOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34503 9TH AVE S STE 330
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8726
Mailing Address - Country:US
Mailing Address - Phone:253-835-8850
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-0001
Practice Address - Country:US
Practice Address - Phone:253-968-2252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-04
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61163082367A00000X
WA60192159163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, InpatientGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2223252Medicaid