Most Relevant Information
Provider Data
| NPI Number: | 1003474933 |
| Provider Name: | JONATHAN ROY JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/05/2019 |
| Last Updated: | 06/11/2019 |
Provider Practice Location
804 LEVEE ST
HOQUIAM
WA
985502527
Practice Location Phone/Fax
| Phone: | 2062233644 |
| Fax: |
Provider Mailing Location
1700 AIRPORT WAY S
SEATTLE
WA
981341618
Provider Mailing Phone/Fax
| Phone: | 2062233644 |
| Fax: |