Individual
TANNA K JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
415 NE 194TH ST UNIT 27, RIDGEFIELD, WA 98642-9404
(360) 977-0946
Mailing address
415 NE 194TH ST UNIT 27, RIDGEFIELD, WA 98642-9404
(360) 977-0946
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60293287
WA
Other
Enumeration date
02/13/2013
Last updated
02/13/2013
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