Individual
MIRIAM D JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12707 120TH AVE NE, SUITE 202, KIRKLAND, WA 98034-7500
(425) 899-4200
(425) 899-4202
Mailing address
11411 NE 124TH ST STE 230, KIRKLAND, WA 98034-4344
(425) 899-4200
(425) 899-4202
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00024675
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1049154
—
WA
01
—
JO4111
REGENCE
WA
Enumeration date
11/01/2006
Last updated
06/12/2024
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