Individual
MARK A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2211 QUEEN ANNE AVE N, SEATTLE, WA 98109-2313
(206) 861-8500
(206) 861-8501
Mailing address
PO BOX 84026, SEATTLE, WA 98124-8426
(206) 861-8500
(206) 861-8501
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00042851
WA
207VX0000X
Obstetrics Physician
MD00042851
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0193241
LABOR AND INDUSTRIES
WA
05
—
8414070
—
WA
Enumeration date
12/21/2006
Last updated
06/02/2021
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