Individual
MRS. MARY FRANCES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
3003 ADDY ST, WASHOUGAL, WA 98671-2672
(360) 835-0681
(360) 835-0703
Mailing address
3003 ADDY ST, WASHOUGAL, WA 98671-2672
(360) 835-0681
(360) 835-0703
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00042173
WA
183500000X
Pharmacist
RPH-0008497
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH00042173
STATE PHARMACIST LICENSE
WA
01
—
RPH-0008497
STATE PHARMACIST LICENSE
OR
Enumeration date
02/27/2012
Last updated
02/27/2012
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