Johansen, Robert

Johansen, Robert is an individual health care provider with primary practice located at 529 Jasmine St , Omak WA 98841-9589. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Johansen, Robert can be contacted via phone (509) 826-1600.

Contact Information

Primary practice address
529 Jasmine St Omak WA 98841-9589
Phone: (509) 826-1600
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA60248541 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA60248541 Washington

Profile Details

NPI number 1639452618
LBN Legal business name Johansen, Robert
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2011
Last updated Sep 10th, 2015 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639452618 NPPES
Washington MEDICAID 1639452618

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