Provider Demographics
NPI:1285133454
Name:JOHNSON, EMILY J (MSN, CNM-BC)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:J
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSN, CNM-BC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:JOY
Other - Last Name:MARTINIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, CNM-BC
Mailing Address - Street 1:1201 TERRY AVE
Mailing Address - Street 2:FL 8
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2735
Mailing Address - Country:US
Mailing Address - Phone:206-287-6300
Mailing Address - Fax:206-341-1250
Practice Address - Street 1:1201 TERRY AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2735
Practice Address - Country:US
Practice Address - Phone:206-287-6225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-02
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61098052367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP61098052OtherARNP MIDWIFE LICENSE
NJ25ME00063701OtherCNM