Individual
SHYLIECA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4708 NE SALMON CREEK ST, VANCOUVER, WA 98686-1606
(360) 869-1322
Mailing address
4708 NE SALMON CREEK ST, VANCOUVER, WA 98686-1606
(360) 869-1322
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10003716
OR
Other
Enumeration date
08/21/2025
Last updated
08/21/2025
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