Organization
OVERLAKE REPRODUCTIVE HEALTH INC., PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN M JOHNSON (MD)
(425) 646-4700
Entity
Organization
Contact information
Practice address
1135 116TH AVE NE, SUITE 640, BELLEVUE, WA 98004-4623
(425) 646-4700
(425) 646-1076
Mailing address
PO BOX 84353, SEATTLE, WA 98124-5653
(425) 646-4700
(425) 646-1076
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8128084
—
WA
Enumeration date
06/20/2006
Last updated
10/22/2007
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