Individual
JACKILEE WYNNELL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7727 SUMMIT VIEW LN, CLINTON, WA 98236-8943
(720) 301-6103
Mailing address
7727 SUMMIT VIEW LN, CLINTON, WA 98236-8943
(720) 301-6103
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN 00108824
WA
Other
Enumeration date
04/28/2016
Last updated
04/28/2016
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