Individual
MS. HAILEY COLEEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1620 E 12TH ST, THE DALLES, OR 97058-3213
(541) 296-9151
Mailing address
PO BOX 271, DALLESPORT, WA 98617-0271
(208) 791-9424
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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