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Individual

SHANA L JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
12303 NE 130TH LN, SUITE 225, KIRKLAND, WA 98034-3099
(425) 899-4012
(425) 899-4013
Mailing address
12303 NE 130TH LN, SUITE 225, KIRKLAND, WA 98034-3099
(425) 899-4012
(425) 899-4013

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200141902RN
OR
163W00000X
Registered Nurse
RN00175004
WA
363L00000X
Nurse Practitioner
Primary
AP60052156
WA
363LW0102X
Women's Health Nurse Practitioner
200250004NP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
028169
OR
Enumeration date
08/16/2006
Last updated
02/01/2016
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