Individual
DR. KELVIE A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
525 LILLY RD NE, OLYMPIA, WA 98506-5101
(360) 493-7230
(360) 493-4180
Mailing address
525 LILLY RD NE, OLYMPIA, WA 98506-5101
(360) 493-7230
(360) 493-4180
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
MD00025100
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8303489
—
WA
Enumeration date
08/02/2005
Last updated
03/01/2021
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