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Individual

MR. DAVID LARS CHRISTIAN JOHNSRUD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BA, MAC, BSN

Contact information

Practice address
1002 15TH ST SW, MAILSTOP 1002-1-TRI, AUBURN, WA 98001-9841
(520) 225-9785
Mailing address
3841 N COUNTRY CLUB RD UNIT 2, TUCSON, AZ 85716-1011
(520) 225-9785

Taxonomy

Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
60607354
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RNP289863
AZ

Other

Enumeration date
03/30/2022
Last updated
10/16/2023
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