Individual
BROOKE ELIZABETH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
34321 32 AVE E, EATONVILLE, WA 98328
(253) 722-3162
Mailing address
PO BOX 1937, EATONVILLE, WA 98328-1937
(253) 722-3162
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00008012
WA
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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