Individual
GARY K JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
118 S 12TH ST, MOUNT VERNON, WA 98274-4036
(360) 336-2178
(360) 336-1995
Mailing address
1400 E KINCAID ST, MOUNT VERNON, WA 98274-4127
(360) 336-2178
(360) 336-1674
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD00011699
WA
207YS0123X
Facial Plastic Surgery Physician
MD00011699
WA
207YX0602X
Otolaryngic Allergy Physician
MD00011699
WA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
MD00011699
WA
208200000X
Plastic Surgery Physician
MD00011699
WA
2086S0122X
Plastic and Reconstructive Surgery Physician
MD00011699
WA
Other
Enumeration date
01/25/2006
Last updated
11/02/2021
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