Individual
MICHAEL W JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7210 40TH ST W, STE 100, UNIVERSITY PLACE, WA 98466
(253) 564-0170
(253) 207-4240
Mailing address
7210 40TH ST W, STE 100, UNIVERSITY PLACE, WA 98466
(253) 564-0170
(253) 207-4240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00039365
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080188803
RAILROAD
WA
01
—
160004
STATE L&I
WA
01
—
160005
STATE L&I
WA
05
—
8311359
—
WA
01
—
8937028
STATE CRIME VICTIMS
WA
Enumeration date
06/29/2006
Last updated
11/16/2010
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