MEDICARE: MS. SARA PATRICIA JOHNSON DC

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	111N00000X	Chiropractor	CH60305127	WA

General Provider Information

NPI Number	:	1710151519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SARA PATRICIA JOHNSON DC

Provider Business Mailing Address
First Line	:	12314 E BROADWAY AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99216-1929
Country	:	US
Telephone Number	:	509-598-8848
Fax Number	:	509-309-3811

Provider Business Practice Location Address
First Line	:	12314 E BROADWAY AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99216-1929
Country	:	US
Telephone Number	:	509-598-8848
Fax Number	:	509-309-3811

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

Provider Enumeration Date	:	04/14/2008
Last Update Date	:	07/20/2021

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