Individual
ANGELA M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DHAT
Contact information
Practice address
2608 KWINA RD, BELLINGHAM, WA 98226-9291
(360) 312-2000
Mailing address
2592 KWINA RD, BELLINGHAM, WA 98226-9278
(360) 312-2000
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
00002
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00002
LUMMI COMMUNITY HEALTH AIDE PROGRAM
WA
Enumeration date
01/04/2021
Last updated
05/07/2024
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