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Individual

LUCY JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
11808 SE 172ND LN APT N303, RENTON, WA 98058
(541) 863-8001
Mailing address
940 W 5TH ST, PORT ANGELES, WA 98363-2113
(541) 863-8001

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A1 60404724
WA

Other

Enumeration date
04/20/2016
Last updated
06/13/2018
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