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General NPI Number Information
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NPI Number | 1134880594
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Entity Type | Individual
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Provider Name | TRAVIS-DEAN M JOHNS DC
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Gender | Male
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Dates
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Enumeration Date | 01/06/2022
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Last Update Date | 01/06/2022
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Provider Practice Location Address
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Address Line | 105 N PARKWAY AVE
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City | BATTLE GROUND
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State | WA
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Zip | 98604-9129
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Country | US
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Telephone | 360-666-6001
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Fax |
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Provider Business Mailing Address
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Address Line | 12417 NE 70TH CIR
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City | VANCOUVER
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State | WA
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Zip | 98682-4885
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Country | US
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Telephone | 619-203-9553
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH61256817
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License Number State | WA
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