Individual
THEODORE J JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
2132 44TH AVE SW, SEATTLE, WA 98116-2102
(206) 261-0160
(206) 937-1933
Mailing address
2132 44TH AVE SW, SEATTLE, WA 98116-2102
(206) 261-0160
(206) 937-1933
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00010180
WA
Other
Enumeration date
03/27/2007
Last updated
04/08/2009
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