Individual
MATTHEW DAVID JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
412 E SPOKANE FALLS BLVD, SPOKANE, WA 99202-2131
(509) 358-7500
Mailing address
2418 E 3RD AVE, SPOKANE, WA 99202-4011
(509) 540-5402
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
IR 60185957
WA
Other
Enumeration date
10/23/2012
Last updated
10/23/2012
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