MEDICARE: DR. SHANE JOHNSON ND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath	07-1033	AZ

General Provider Information

NPI Number	:	1356523070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANE JOHNSON ND

Provider Business Mailing Address
First Line	:	8010 E MCDOWELL RD STE 111
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85257-3868
Country	:	US
Telephone Number	:	480-970-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	8010 E MCDOWELL RD STE 111
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85257-3868
Country	:	US
Telephone Number	:	480-970-0000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2007
Last Update Date	:	03/18/2008

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Directions to “ DR. SHANE JOHNSON ND” Practice Location

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