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General NPI Number Information
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NPI Number | 1881240869
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Entity Type | Individual
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Provider Name | DEREK N JOHNSTON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/14/2019
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 27520 COVINGTON WAY SE
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City | COVINGTON
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State | WA
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Zip | 98042-9100
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Country | US
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Telephone | 253-796-1011
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Fax |
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Provider Business Mailing Address
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Address Line | 2224 170TH AVE E
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City | LAKE TAPPS
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State | WA
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Zip | 98391-4901
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Country | US
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Telephone | 253-209-9445
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH60950566
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License Number State | WA
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