Individual
TERRI L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
529 JASMINE ST, OMAK, WA 98841-9589
(509) 826-1600
(509) 826-3633
Mailing address
PO BOX 3188, OMAK, WA 98841-3188
(509) 826-1600
(509) 826-3633
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30007367
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0210789
L&I
WA
01
—
8941928
CV
WA
05
—
9637950
—
WA
Enumeration date
07/19/2006
Last updated
12/05/2012
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