Individual
BRIAN R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
S.P.
Contact information
Practice address
626 120TH AVE NE, SUITE B201, BELLEVUE, WA 98005-3077
(425) 556-6330
(425) 556-6325
Mailing address
11511 NE 10TH ST, BELLEVUE MEDICAL CENTER, BELLEVUE, WA 98004-8578
(425) 502-3898
(425) 502-4233
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00003248
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8410839
—
WA
Enumeration date
02/02/2007
Last updated
10/27/2015
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