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NPI Code Detail

MEDICARE: MRS. MARY FRANCES JOHNSON R.PH.

MEDICARE: MRS. MARY FRANCES JOHNSON R.PH.
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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPH00042173WA
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistRPH-0008497OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PH00042173OTHERWASTATE PHARMACIST LICENSE
2RPH-0008497OTHERORSTATE PHARMACIST LICENSE

General Provider Information

NPI Number : 1700150414
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY FRANCES JOHNSON R.PH.
Provider Business Mailing Address
First Line : 3505 SE 192ND AVE
Second Line :
City : VANCOUVER
State : WA
Zip : 98683-1436
Country : US
Telephone Number : 360-253-3043
Fax Number : 360-253-3031
Provider Business Practice Location Address
First Line : 3505 SE 192ND AVE
Second Line :
City : VANCOUVER
State : WA
Zip : 98683-1436
Country : US
Telephone Number : 360-253-3043
Fax Number : 360-253-3031
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2012
Last Update Date : 05/12/2026

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