Provider Demographics
NPI:1487941332
Name:JOHNSTON, TRACY ANN (DPT)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:ANN
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:ANN
Other - Last Name:KUHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1855 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-1966
Mailing Address - Country:US
Mailing Address - Phone:509-559-5038
Mailing Address - Fax:509-559-5027
Practice Address - Street 1:1111 E WESTVIEW CT
Practice Address - Street 2:SUITE A
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1376
Practice Address - Country:US
Practice Address - Phone:509-465-1749
Practice Address - Fax:509-465-1748
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60225614225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist