# MR. CHRIS DOUGLAS JOHNSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1992753875
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 10046 | MN | — |
| 363A00000X | Physician Assistant | 2120-023 | WI | Yes |
| 363AS0400X | Surgical Physician Assistant | PA60468333 | WA | — |

## Other

- **Enumeration date:** 05/04/2006
- **Last updated:** 03/01/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1992753875 | — | WI |
| 05 | — | 2284707000 | — | MN |