NPI 1417874066

Dallisa Johnson, CPHTADV

Practitioner Pharmacy Technician Moscow, ID

Practice location

Address: 700 S Main St, Moscow, ID 83843-3046
Phone: (208) 883-6245
Mailing address: 517 Elm St # 194, Troy, ID 83871-0077

Registered specialties

Pharmacy Technician Primary

Pharmacy Service Providers Taxonomy 183700000X Licence CT1222 (ID)

Other Pharmacy Technician providers in Idaho →

Registry record

NPI: 1417874066
Entity type: Individual
Sex (as registered): Female
NPI issued: 3 Jul 2026
Record last updated: 3 Jul 2026

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.