Individual
ANDREA JOHANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20618 142ND AVE SE, KENT, WA 98042-3066
(415) 891-5110
Mailing address
20618 142ND AVE SE, KENT, WA 98042-3066
(415) 891-5110
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP61590871
WA
Other
Enumeration date
06/26/2023
Last updated
08/17/2024
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