Individual
WYATT JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ABOC
Contact information
Practice address
2203 SW COURT PL, PENDLETON, OR 97801-1896
(541) 276-2905
Mailing address
2203 SW COURT PL, PENDLETON, OR 97801-1896
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
249306
OR
Other
Enumeration date
05/19/2023
Last updated
05/19/2023
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