Individual
DR. SHANE R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
560 GAGE BLVD, SUITE 102, RICHLAND, WA 99352-8650
(509) 942-3135
(509) 627-1188
Mailing address
560 GAGE BLVD, SUITE 102, RICHLAND, WA 99352-8650
(509) 942-3135
(509) 627-1188
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH60361579
WA
1835G0303X
Geriatric Pharmacist
Primary
PH60361579
WA
1835P2201X
Ambulatory Care Pharmacist
PH60361579
WA
Other
Enumeration date
08/15/2012
Last updated
03/07/2023
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