Individual
DR. JEREMIAH O. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
304 N CHELAN AVE, WENATCHEE, WA 98801-2107
(509) 663-0068
(509) 663-0060
Mailing address
620 N. EMERSON AVE, SUITE #101, WENATCHEE, WA 98801
(509) 663-0068
(509) 663-0060
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
60337452
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2036913
—
WA
Enumeration date
08/31/2006
Last updated
02/26/2020
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