Individual
MR. MICHAEL COTTRELL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3812 W. MERCER WAY, MERCER ISLAND, WA 98040
(206) 232-8158
Mailing address
P.O. BOX 994, MERCER ISLAND, WA 98040
(206) 375-9583
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
10052933
WA
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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