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General NPI Number Information
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NPI Number | 1184605347
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Entity Type | Individual
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Provider Name | CHATT ALLAN JOHNSON MD
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Gender | Male
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 9040 JACKSON AVENUE
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City | TACOMA
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State | WA
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Zip | 98431-4882
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Country | US
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Telephone | 253-968-2252
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Fax |
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Provider Business Mailing Address
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Address Line | 9040 JACKSON AVE
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City | TACOMA
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State | WA
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Zip | 98431-0001
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Country | US
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Telephone | 253-958-2252
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MD60327871
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | J8003
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD60327871
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | J8003
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | J8003
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License Number State | TX
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