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:

Map and Directions

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 15 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

State	Type	Number	Issuer
All States	NPI	1114030566	NPPES
Washington	MEDICAID	8321150

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