Johnson, Crystal J

Johnson, Crystal J is an sole proprietor health care provider with primary practice located at 11608 N Kathy Dr , Spokane WA 99218-2725. She recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Dietitian, Registered, Dietary & Nutritional Service Providers / Nutrition, Metabolic. Dietary & Nutritional Service Providers / Dietitian, Registered is her primary health care specialty. Johnson, Crystal J can be contacted via phone (509) 869-2330.

Contact Information

Primary practice address
11608 N Kathy Dr Spokane WA 99218-2725
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X DI00001258 Washington
Dietary & Nutritional Service Providers / Nutrition, Metabolic 133VN1006X DX3074 Maryland

Profile Details

NPI number 1306839956
LBN Legal business name Johnson, Crystal J
Credentials MS, RD, CDE, CD, LD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 30th, 2005
Last updated Feb 9th, 2011 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306839956 NPPES
Washington MEDICAID 8299679

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