Individual
MS. ROBERTA LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
INTREPID SPIRIT CENTER 90390 GARDNER LOOP, TACOMA, WA 98431-0001
(253) 968-9017
Mailing address
8634 QUINAULT DR NE, OLYMPIA, WA 98516-5826
(360) 789-5261
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN00047974
WA
Other
Enumeration date
01/26/2018
Last updated
03/17/2018
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