Individual
MS. SOSSAN JAMILAH JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
109 SW 366TH ST, FEDERAL WAY, WA 98023-7372
(603) 969-7197
Mailing address
16085 NW EDWARD CT, BEAVERTON, OR 97006-7209
(603) 969-7197
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60600188
WA
Other
Enumeration date
11/10/2014
Last updated
10/30/2017
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