Provider Demographics
NPI:1871949438
Name:JOHNSON, GINGER DIANNE (CNP)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:DIANNE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:PROF
Other - First Name:VIRGINIA
Other - Middle Name:DIANNE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CDP
Mailing Address - Street 1:8212 S MARCH POINT RD
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-8684
Mailing Address - Country:US
Mailing Address - Phone:360-588-2800
Mailing Address - Fax:360-588-2808
Practice Address - Street 1:8212 S MARCH POINT RD
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-8684
Practice Address - Country:US
Practice Address - Phone:360-588-2800
Practice Address - Fax:360-588-2808
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP 60520526101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)