Individual
DR. MARK DOUGLAS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., MTM&H
Contact information
Practice address
933 RED APPLE RD, WENATCHEE, WA 98801-3370
(509) 665-6210
(509) 667-3310
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 662-1511
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD60755882
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033105788
—
WA
01
—
381440
LNI
WA
Enumeration date
09/27/2005
Last updated
03/12/2018
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