Individual
JAMEY L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
500 SW RAMSEY AVE, GRANTS PASS, OR 97527-5543
(541) 472-5110
(541) 472-7268
Mailing address
2825 E BARNETT RD, MSS, MEDFORD, OR 97504-8332
(541) 789-4281
(541) 789-4806
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
201393465CRNA
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307140000
—
MN
05
—
44379200
—
WI
05
—
500683049
—
OR
01
—
P00405200
MEDICARE RAILROAD
MN
Enumeration date
04/25/2007
Last updated
07/28/2023
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