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General NPI Number Information
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NPI Number | 1528640430
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Entity Type | Individual
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Provider Name | TRENT ANDREW JOHNSON MD
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Gender | Male
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Dates
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Enumeration Date | 04/21/2021
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Last Update Date | 11/09/2024
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Provider Practice Location Address
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Address Line | 800 W 5TH AVE
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City | SPOKANE
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State | WA
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Zip | 99204-2803
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Country | US
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Telephone | 253-263-7114
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Fax |
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Provider Business Mailing Address
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Address Line | 5002 S MORRILL LN
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City | SPOKANE
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State | WA
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Zip | 99223-1583
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Country | US
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Telephone | 385-225-5853
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 61535749
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License Number State | WA
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