Johnson, Delisha M
Johnson, Delisha M is an individual health care provider with primary practice located at 320 S Kitsap Blvd , Port Orchard WA 98366-3778. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Johnson, Delisha M can be contacted via phone (360) 876-7215.Contact Information
Primary practice address
320 S Kitsap Blvd
Port Orchard WA 98366-3778
Phone: (360) 876-7215
Fax: (360) 876-6721
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA10004048 | Washington |
Profile Details
| NPI number | 1114030566 |
|---|---|
| LBN Legal business name | Johnson, Delisha M |
| Credentials | PAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 17th, 2006 |
| Last updated | Feb 9th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114030566 | NPPES |
| Washington | MEDICAID | 8321150 |
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