Doctor Name: | CARLA JOHNSON |
NPI Number: | 1912187378 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMP |
License Number: | MA00023300 |
Business Practice Address: | 1206 N Dolarway Rd Suite # 211 Ellensburg, WA - 989268392 |
Business Phone Number: | 5099256869 |
Business Fax Number: | |
Mailing Address: | 2106 W Clearview Dr, ELLENSBURG |
State: | WA |
Postal Code: | 989262331 |
Phone Number: | 5098991959 |
Fax Number: | 5099333658 |
NPI Enumeration Date: | 11/13/2007 |
NPI Last Update Date: | 07/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA00023300 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |