Individual
JENNIFER JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
6515 12TH AVE NE, SEATTLE, WA 98115-6753
(206) 605-0433
Mailing address
6515 12TH AVE NE, SEATTLE, WA 98115-6753
(206) 605-0433
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00011677
WA
Other
Enumeration date
06/08/2007
Last updated
07/08/2007
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