Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD60144427 | WA |
Y | 208600000X | Surgeon | MD60144427 | WA |
NPI | 1003062290 |
---|---|
Provider Name | Dr. Matthew Alexander Johnston |
First Address | Seattle, WA 98144-7125 |
Second Address | Seattle, WA 98122-3913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2008 |
Last Update Date | 20/07/2010 |