Johnston, Tessa C
Johnston, Tessa C is an individual health care provider with primary practice located at 935 Royal Ave , Medford OR 97504-6140. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Johnston, Tessa C can be contacted via phone (541) 779-2211.Contact Information
Primary practice address
935 Royal Ave
Medford OR 97504-6140
Phone: (541) 779-2211
Fax: (541) 779-8778
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3177AT | Oregon |
Profile Details
| NPI number | 1174620835 |
|---|---|
| LBN Legal business name | Johnston, Tessa C |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 17th, 2006 |
| Last updated | Jun 16th, 2011 - about 14 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 | 1174620835 | NPPES |
| Oregon | MEDICAID | 026488 |
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