Individual
MRS. CAROL RENEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
321 N PINES RD, SUITE C, SPOKANE VALLEY, WA 99206-5176
(509) 879-6025
Mailing address
321 N PINES RD, SUITE C, SPOKANE VALLEY, WA 99206-5176
(509) 879-6025
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00011653
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0242525
STATE OF WASHINGTON LABOR AND INDUSTRIES
WA
Enumeration date
01/12/2009
Last updated
01/12/2009
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