Individual
HOLLY GULLIVER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, OTR/L
Contact information
Practice address
16250 NE 74TH ST, REDMOND, WA 98052-7817
(425) 936-1200
Mailing address
18974 FOREST PARK DR NE, LAKE FOREST PARK, WA 98155-2436
(206) 769-1748
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
60314820
WA
225X00000X
Occupational Therapist
Primary
60314820
WA
Other
Enumeration date
03/25/2013
Last updated
03/25/2016
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