NPI 1033345715

Wayne Johnson, LMP

Practitioner Specialist Olympia, WA

Practice location

Address: 2401 Bristol CT SW Suite A-103, Olympia, WA 98502-6003
Phone: (360) 878-7506

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence MA00024292 (WA)

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Registry record

NPI: 1033345715
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Jun 2009
Record last updated: 8 Jun 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.