Provider Demographics
NPI:1043060999
Name:JOHNSON, CASSANDRA F
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:F
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10224 10TH AVENUE CT S
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-2795
Mailing Address - Country:US
Mailing Address - Phone:509-999-8485
Mailing Address - Fax:
Practice Address - Street 1:10224 10TH AVENUE CT S
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-2795
Practice Address - Country:US
Practice Address - Phone:509-999-8485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant