Individual
MRS. DANA ILENE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP, MMP
Contact information
Practice address
11803 101ST AVE CT E, STE 100, PUYALLUP, WA 98373-3473
(253) 435-1285
(253) 445-8632
Mailing address
25506 157TH AVE SE, COVINGTON, WA 98042-4161
(253) 435-1285
(253) 445-8632
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00014833
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0195842
L AND I
WA
01
—
1880J0
REGENCE
—
Enumeration date
08/16/2005
Last updated
07/08/2007
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