Individual
STEVENSON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
800 W UNIVERSITY PKWY, OREM, UT 84058-6703
(801) 863-7982
Mailing address
2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
(541) 882-6311
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA221837
OR
Other
Enumeration date
08/11/2023
Last updated
07/13/2024
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