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Individual

MR. CLYDE W JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, CHT

Contact information

Practice address
3101 NORTHUP WAY STE 301, BELLEVUE, WA 98004-1449
(425) 462-5006
(425) 462-5019
Mailing address
510 8TH AVE NE STE 320, ISSAQUAH, WA 98029-5436
(425) 462-5006
(425) 462-5019

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT00005729
WA
2251H1200X
Hand Physical Therapist
Primary
PT00005729
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023366
WA
Enumeration date
11/29/2006
Last updated
02/22/2023
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