Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kassandra Johnson

Individual provider Athletic Trainer · NPI 1417518408

Kassandra Johnson is an Athletic Trainer in Moscow, Idaho. Licensed in Idaho. Registered with an NPI since 2019.

Licensed in
ID
In the registry since
2019

Practice location Address checks out

875 Perimeter Dr
Moscow, ID 83844-9803
Phone: (208) 885-6111
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AT-649 (ID)

Record details

NPI number1417518408
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 21, 2019
Last updated in NPPESJune 21, 2019
Mailing address875 Perimeter Dr, Moscow, ID 83844-9803

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