Individual
MRS. ELISABETH COURTENAY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1712 SOUTH 17TH STREET, TACOMA, WA 98405
(253) 571-4500
Mailing address
P.O. BOX 1357, TACOMA, WA 98401-1357
(253) 571-4500
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT 00007717
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18667
TPS EMPLOYEE ID
WA
Enumeration date
10/03/2012
Last updated
10/03/2012
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