Individual
DR. THEODORE MARTIN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
500 LILLY RD NE, #205, OLYMPIA, WA 98506-5195
(360) 413-8222
(360) 413-8205
Mailing address
500 LILLY RD NE, #205, OLYMPIA, WA 98506-5195
(360) 413-8222
(360) 413-8205
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY2977
WA
Other
Enumeration date
09/13/2006
Last updated
07/08/2007
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