Individual
DELISHA M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
320 S KITSAP BLVD, PORT ORCHARD, WA 98366-3778
(360) 876-7215
(360) 876-6721
Mailing address
PO BOX 960, BREMERTON, WA 98337
(360) 478-2366
(360) 373-2096
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004048
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8321150
—
WA
Enumeration date
08/17/2006
Last updated
02/09/2011
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