Provider Demographics
NPI:1861142622
Name:JOHNSTON, CAYCE MAE
Entity type:Individual
Prefix:
First Name:CAYCE
Middle Name:MAE
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28235 SE 268TH ST
Mailing Address - Street 2:
Mailing Address - City:RAVENSDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98051-8816
Mailing Address - Country:US
Mailing Address - Phone:206-947-2190
Mailing Address - Fax:
Practice Address - Street 1:28235 SE 268TH ST
Practice Address - Street 2:
Practice Address - City:RAVENSDALE
Practice Address - State:WA
Practice Address - Zip Code:98051-8816
Practice Address - Country:US
Practice Address - Phone:206-947-2190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer