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Individual

MRS. TIFFANY DAWN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
9916 NE HIGHWAY 99, VANCOUVER, WA 98686-5608
(503) 449-7145
Mailing address
2723 NE MAPLEWOOD DR, VANCOUVER, WA 98665-0178
(503) 449-7145

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
201610057LPN
OR
164W00000X
Licensed Practical Nurse
Primary
LP61315919
WA

Other

Enumeration date
10/16/2017
Last updated
06/12/2023
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