Healthcare Provider Details

I. General information

NPI: 1346663580
Provider Name (Legal Business Name): RENEE JOHNSTON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2014
Last Update Date: 01/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7317 35TH AVE NE
SEATTLE WA
98115-5918
US

IV. Provider business mailing address

7317 35TH AVE NE
SEATTLE WA
98115-5918
US

V. Phone/Fax

Practice location:
  • Phone: 206-417-8066
  • Fax: 206-417-8076
Mailing address:
  • Phone: 206-417-8066
  • Fax: 206-417-8076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number60389147
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: