Individual
CHARMAINE R ALLEN-JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
619 DIAGONAL ST, CLARKSTON, WA 99403-2041
(509) 758-9003
(509) 758-9001
Mailing address
165 SOUTHPORT AVE, LEWISTON, ID 83501-4523
(208) 743-3142
(208) 743-3142
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP3005439
WA
363LF0000X
Family Nurse Practitioner
Primary
NP451A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1786607
—
WA
Enumeration date
03/29/2007
Last updated
10/26/2010
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