Individual
JASON RUSSELL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
9330 59TH AVE SW, LAKEWOOD, WA 98499-2858
(253) 620-5015
(253) 620-5831
Mailing address
9330 59TH AVE SW, LAKEWOOD, WA 98499-2858
(253) 620-5015
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60642223
WA
Other
Enumeration date
11/28/2011
Last updated
04/04/2016
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