Individual
JEREMIAH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSN
Contact information
Practice address
850 MAPLE ST., MEDICAL LAKE, WA 99022
(509) 565-4000
Mailing address
13310 E MISSION AVE, APT #114, SPOKANE VALLEY, WA 99216-2723
(509) 481-7650
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60268562
WA
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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