Individual
DAVID MICHAEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
17400 RESERVATION RD, LA CONNER, WA 98257-8801
(360) 466-3167
Mailing address
PO BOX 683, LA CONNER, WA 98257-0683
(360) 466-3167
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60792211
WA
Other
Enumeration date
07/26/2016
Last updated
10/12/2017
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