1316290315 NPI number — MRS. CHERI JO JOHNSON MED, OTL

Table of content: MRS. CHERI JO JOHNSON MED, OTL (NPI 1316290315)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316290315 NPI number — MRS. CHERI JO JOHNSON MED, OTL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOHNSON
Provider First Name:
CHERI
Provider Middle Name:
JO
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MED, OTL
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316290315
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19307 E. CATALDO
Provider Second Line Business Mailing Address:
CENTRAL VALLEY SCHOOL DISTRICT SPECIAL SERVICES
Provider Business Mailing Address City Name:
SPOKANE VALLEY
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-223-5513
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10304 E 9TH AVE
Provider Second Line Business Practice Location Address:
EARLY LEARNING CENTER
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99206-3574
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-228-5513
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/16/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225XP0200X , with the licence number:  OT00001122 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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