Individual
DR. JAN GARY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
945 11TH AVE, SUITE B, LONGVIEW, WA 98632-2555
(360) 414-8600
(360) 636-7372
Mailing address
945 11TH AVE, SUITE B, LONGVIEW, WA 98632-2555
(360) 414-8600
(360) 636-7372
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2721
WA
Other
Enumeration date
09/15/2006
Last updated
07/08/2007
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