Provider Demographics
NPI:1699145607
Name:JOHNSON, SAFIA KASSAM (ND)
Entity type:Individual
Prefix:DR
First Name:SAFIA
Middle Name:KASSAM
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:SAFIA
Other - Middle Name:MOHAMED
Other - Last Name:KASSAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:21619 119TH CT SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-3957
Mailing Address - Country:US
Mailing Address - Phone:206-888-1195
Mailing Address - Fax:
Practice Address - Street 1:711 COLUMBIA STREET
Practice Address - Street 2:
Practice Address - City:NEW WESTMINSTER
Practice Address - State:BC
Practice Address - Zip Code:V3M1B1
Practice Address - Country:CA
Practice Address - Phone:604-544-7656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-02
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60603258175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath