Individual
RANDELLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2555 MARVIN RD NE, LACEY, WA 98516-3138
(360) 413-4200
Mailing address
2555 MARVIN RD NE, LACEY, WA 98516-3138
(360) 413-4200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RN61184028
WA
Other
Enumeration date
02/19/2026
Last updated
02/19/2026
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