Individual
SHANNON JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2818 NE 145TH ST, SHORELINE, WA 98155-7556
(206) 418-2900
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60628729
WA
Other
Enumeration date
02/12/2016
Last updated
09/10/2024
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