Basic Information
| Provider Information | |||||||||
| NPI: | 1194749820 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JOHNS | ||||||||
| FirstName: | JONATHAN | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2947 | ||||||||
| Address2: | |||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989072947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092487849 | ||||||||
| FaxNumber: | 5092495042 | ||||||||
| Practice Location | |||||||||
| Address1: | 3003 TIETON DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989023679 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094542229 | ||||||||
| FaxNumber: | 5094547979 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MD00043447 | WA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.