Individual
HOLLY N JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1706 MERIDIAN S, SUITE 120, PUYALLUP, WA 98371-7516
(253) 848-8797
(253) 446-3239
Mailing address
1706 MERIDIAN S, SUITE 120, PUYALLUP, WA 98371-7516
(253) 848-8797
(253) 446-3239
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD00037249
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8243396
DSHS NUMBER
WA
Enumeration date
01/03/2006
Last updated
07/08/2007
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