Star Marie Johnson, is a
Peer Specialist based in Longview, Washington. Star Marie Johnson is licensed to practice in Washington (license number CG60987591) and her current practice location is
748 14th Ave, Longview, Washington. She can be reached at her office (for appointments etc.) via phone at
(360) 200-5419.
NPI number for Star Marie Johnson is 1235783366 and her current mailing address is Po Box 2394, Longview, Washington. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1235783366.
Healthcare Provider's Profile
| Full Name | Star Marie Johnson |
|---|
| Gender | Female |
|---|
| Speciality | Peer Specialist |
|---|
| Location | 748 14th Ave, Longview, Washington |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1235783366
- Provider Enumeration Date: 07/26/2019
- Last Update Date: 11/13/2020
Medical Identifiers
Medical identifiers for Star Marie Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1235783366 | NPI | - | NPPES |
| 2140147 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | CO61000223 (Washington) | Secondary |
| 175T00000X | Peer Specialist | CG60987591 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Star Marie Johnson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Star Marie Johnson,
Po Box 2394,
Longview, WA 98632
Ph: (360) 200-5419 | Star Marie Johnson,
748 14th Ave,
Longview, WA 98632-2315
Ph: (360) 200-5419 |
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