Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DE60058099 | WA |
NPI | 1063615862 |
---|---|
Provider Name | Dr. Erin Leigh Johnson |
First Address | Spokane, WA 99203-3917 |
Second Address | Spokane, WA 99203-3917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2007 |
Last Update Date | 10/12/2013 |