Individual
MR. JEFFREY A JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPO
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
PS00000038
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164988
—
OR
05
—
9035353
—
WA
Enumeration date
09/29/2005
Last updated
07/10/2008
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