Individual
GREGORY CHARLES JOHNSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
9600 VETERANS DR SW, TACOMA, WA 98493-0003
(253) 583-1232
Mailing address
6724 51ST AVE E, TACOMA, WA 98443-2335
(253) 561-1376
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD60861995
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OD60861995
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
07/05/2018
Last updated
07/05/2018
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