Individual
DR. EDWARD D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
840 S MEYERS ST, KETTLE FALLS, WA 99141
(509) 685-7848
(509) 684-5817
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
(509) 944-9644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00036372
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125338
L & I
—
05
—
8238982
—
WA
01
—
8924161
L & I CRIME VICTIMS
—
Enumeration date
10/13/2005
Last updated
05/19/2021
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