Individual
DR. DOUGLAS R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1115 SE 164TH AVE DEPT 358, VANCOUVER, WA 98683-8004
(541) 902-1734
Mailing address
1115 SE 164TH AVE DEPT 358, VANCOUVER, WA 98683-8004
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO150688
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048884
—
OR
01
—
93-0937095
CURRY HEALTH DISTRICT TAX ID
OR
01
—
R0000ZGBDG
CURRY MEDICAL CENTER - MEDICARE PART B
OR
Enumeration date
08/31/2006
Last updated
09/01/2016
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