Individual
GAYLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12123 SW 69TH AVE, TIGARD, OR 97223-8514
(971) 708-7600
Mailing address
1498 SE TECH CENTER PL STE 240, VANCOUVER, WA 98683-5508
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
12/04/2018
Last updated
04/02/2021
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