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General NPI Number Information
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NPI Number | 1124464573
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Entity Type | Individual
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Provider Name | JOHANNA M THOMPSON PHARM D
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Gender | Female
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Dates
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Enumeration Date | 05/13/2013
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 610 E MAIN ST
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City | ELMA
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State | WA
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Zip | 98541-9353
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Country | US
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Telephone | 360-495-5639
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Fax |
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Provider Business Mailing Address
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Address Line | 1570 N 5TH ST
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City | MCCLEARY
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State | WA
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Zip | 98557-9574
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Country | US
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Telephone | 360-581-9571
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | RP446836
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PH60276447
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License Number State | WA
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