Individual
TIMOTHY R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
515 MINOR AVE, #300, SEATTLE, WA 98104
(206) 386-9500
(206) 386-9605
Mailing address
PO BOX 3489, SEATTLE, WA 98114-3489
(206) 386-9500
(206) 386-9605
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00032104
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108314
LABOR & INDUSTRY
WA
05
—
8178014
—
WA
Enumeration date
01/17/2006
Last updated
10/07/2020
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