Individual
SHAWNELLE ILONA JOHANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30601 34TH PL S, AUBURN, WA 98001-3201
(206) 954-0907
Mailing address
10839 14TH AVE S, SEATTLE, WA 98168-1702
(206) 954-0907
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60527011
WA
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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