Individual
JEANETTE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
8811 S TACOMA WAY STE 106, LAKEWOOD, WA 98499-4595
(253) 302-3826
(253) 267-5212
Mailing address
8811 S TACOMA WAY STE 106, LAKEWOOD, WA 98499-4595
(253) 302-3826
(253) 267-5212
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60768670
WA
Other
Enumeration date
05/07/2019
Last updated
05/07/2019
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