Individual ProviderAnderia JohnsonCounselorBehavioral Health & Social Service ProvidersPractice Address1700 Airport Way S, Seattle, WA 98134-1618(425) 653-4960(850) 322-7659PECOS EnrollmentBased on the most recent information from CMS, provider Anderia Johnson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1295384592Provider TypeIndividualFull NameJohnson, AnderiaGenderFemaleSole ProprietorNoEnumeration Date9/9/2019Last Updated12/28/2019Contact InformationPractice LocationPractice Address1700 Airport Way S, Seattle, WA 98134-1618Phone(425) 653-4960FaxUnlisted FaxMailing LocationMailing Address17630 143rd Ave SE Apt D204, Renton, WA 98058-9225Phone(850) 322-7659FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101Y00000XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer