Provider Demographics
NPI:1407698061
Name:JOHNSON, EMMANUEL JUWON
Entity type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:JUWON
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8319 E GILMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-1120
Mailing Address - Country:US
Mailing Address - Phone:904-728-0306
Mailing Address - Fax:
Practice Address - Street 1:9725 3RD AVE NE STE 100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2049
Practice Address - Country:US
Practice Address - Phone:206-706-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist