DR. KATHRYN M JOHNSON (PH.D.) – Clinical Psychologist, NPI 1780672030

DR. KATHRYN M JOHNSON (PH.D.) is a healthcare provider. based in Seattle, Washington. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. PY00003314 (WA). The NPI Number for DR. KATHRYN M JOHNSON (PH.D.) is 1780672030

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
DR. KATHRYN M JOHNSON (PH.D.)
NPI
1780672030
Phone
Not provided
Address
1014 NE 80TH ST
Enumeration Date
11 October 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4253394299
Graduation Year
2004 (22 years ago)
PAC ID
5698781623
Group Practice PAC ID
6406752153
Professional Enrollment ID
I20060301000220
Address ID
WA981335064SH1201XSTXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

775 CLINICAL PSYCHOLOGIST in WA

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Provider Addresses for DR. KATHRYN M JOHNSON (PH.D.)

  • 1014, Northeast 80th Street, Green Lake, Seattle, King County, Washington, 98115, United States

    SEATTLE, WA 98115

    Phone:

    Type: Mailing

  • West Marine View Drive, Northwest Everett, Everett, Snohomish County, Washington, 98201, United States

    SUITE 106

    EVERETT, WA 982012094

    Phone: (425) 339-5453

    Fax: (425) 252-4441

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-03-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060301000220IClinical PsychologistWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98115)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406752153View full group profile
NameSpecialtyState
-OR
-WA
-WA
P A T H O L O G YTN
Nurse PractitionerWA
Diagnostic RadiologyWA
Nurse PractitionerWA
Physical Therapist In Private PracticeWA
O T O L A R Y N G O L O G YWA
Emergency MedicineOR

Reviews

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Frequently asked questions

What NPI should I save for DR. KATHRYN M JOHNSON (PH.D.)?
Save NPI 1780672030 if you need a stable reference for DR. KATHRYN M JOHNSON (PH.D.).
Is DR. KATHRYN M JOHNSON (PH.D.) currently active in the NPI registry?
CMS-published data lists DR. KATHRYN M JOHNSON (PH.D.) as an active registrant.
Does DR. KATHRYN M JOHNSON (PH.D.) list a primary specialty?
If you are matching referrals, note Clinical Psychologist for DR. KATHRYN M JOHNSON (PH.D.). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. KATHRYN M JOHNSON (PH.D.)?
The page summarizes Seattle, Washington for DR. KATHRYN M JOHNSON (PH.D.); expand the address list for detail.
Is DR. KATHRYN M JOHNSON (PH.D.) a real provider?
This page reflects official NPPES data for NPI 1780672030. Always confirm identity and privileges with the practice and licensing boards.

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