Provider Demographics
NPI:1073490769
Name:JOHNSON, LAURA E
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:E
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAURE
Other - Middle Name:E
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:902 ALASKA AVE E
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-7121
Mailing Address - Country:US
Mailing Address - Phone:971-303-9590
Mailing Address - Fax:
Practice Address - Street 1:902 ALASKA AVE E
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-7121
Practice Address - Country:US
Practice Address - Phone:971-303-9590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty