Individual
MR. JEFFREY A JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPO
Contact information
Practice address
919 W MAIN ST, WALLA WALLA, WA 99362-2746
(509) 525-8322
(509) 252-2982
Mailing address
PO BOX 662, WALLA WALLA, WA 99362-0016
(509) 525-8322
(509) 525-2982
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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