Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YP0228X | Pediatric Otolaryngology | 35.097031 | OH |
Y | 207YP0228X | Pediatric Otolaryngology | MD 60340296 | WA |
NPI | 1477715696 |
---|---|
Provider Name | Kaalan E Johnson |
First Address | Seattle, WA 98105-3901 |
Second Address | Seattle, WA 98105-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2008 |
Last Update Date | 13/07/2013 |