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General NPI Number Information
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NPI Number | 1093941486
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Entity Type | Organization
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Legal Business Name | DR. ERIK R. JOHNSON DC PS, INC
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Dates
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Enumeration Date | 05/31/2009
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Last Update Date | 05/31/2009
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Provider Practice Location Address
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Address Line | 1 LAKE BELLEVUE DR STE 107
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City | BELLEVUE
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State | WA
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Zip | 98005-2417
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Country | US
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Telephone | 425-455-5390
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Fax |
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Provider Business Mailing Address
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Address Line | 1 LAKE BELLEVUE DR STE 107
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City | BELLEVUE
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State | WA
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Zip | 98005-2417
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Country | US
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Telephone | 425-455-5390
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERIK R JOHNSON
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Credential | DC
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Telephone | 425-455-5390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH00001219
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License Number State | WA
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