Individual
GWEN E JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, ATC
Contact information
Practice address
901 12TH AVE, SEATTLE, WA 98122-4411
(206) 296-5452
Mailing address
5225 50TH AVE NE APT 103, SEATTLE, WA 98105-2872
(503) 332-6706
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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