Individual
DR. DIANE ELIZABETH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
219 W PATISON ST, PORT HADLOCK, WA 98339-9710
(360) 379-8821
(360) 379-8821
Mailing address
P.O. BOX 37, PORT HADLOCK, WA 98339
(360) 379-8821
(360) 379-8821
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY00001854
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7110810
—
WA
Enumeration date
05/10/2007
Last updated
11/28/2011
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