Individual
ENNIS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
811 MADISON ST, SUITE 202, EVERETT, WA 98203-4543
(425) 212-4200
Mailing address
PO BOX 2569, EVERETT, WA 98213-0569
(425) 212-4200
(425) 212-4241
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/30/2014
Last updated
10/04/2014
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