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General NPI Number Information
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NPI Number | 1972996874
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Entity Type | Individual
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Provider Name | KARI JOHNSTON D.C.
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Gender | Female
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Dates
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Enumeration Date | 03/17/2015
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Last Update Date | 03/17/2015
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Provider Practice Location Address
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Address Line | 1167 NW WALLULA AVENUE #316
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City | GRESHAM
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State | OR
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Zip | 97030
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Country | US
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Telephone | 785-527-3590
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Fax |
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Provider Business Mailing Address
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Address Line | 1167 NW WALLULA AVE #316
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City | GRESHAM
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State | OR
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Zip | 97030-3666
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Country | US
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Telephone | 785-527-3590
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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 | CH60533870
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License Number State | WA
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