Individual
KATHRYN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 267-5151
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 267-5151
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD218480
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2018
Last updated
01/09/2024
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