Individual
KELLY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1230 7TH AVE, LONGVIEW, WA 98632-3198
(800) 813-2000
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2099
(800) 813-2000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
041308882
IL
363L00000X
Nurse Practitioner
Primary
AP70027451
WA
Other
Enumeration date
01/08/2013
Last updated
06/10/2026
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