Individual
MR. RAY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4446 88TH AVE SE, MERCER ISLAND, WA 98040
(206) 939-9898
Mailing address
4446 88TH AVE SE, MERCER ISLAND, WA 98040
(206) 939-9898
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
819241
WA
Other
Enumeration date
04/21/2016
Last updated
04/21/2016
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