Search › Idaho › 207Q00000X
Shae Johnson, DO
NPI 1669588315 · on the registry since 2006 · sole proprietor
Practice
- Address
- 6533 Emerald Street
Boise, ID 83704 - Phone
- (208) 302-5100
- Fax
- (208) 302-5155
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Also registered as
- 207Q00000X
207Q00000X - Licence states on file
- UT, OR, ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-11-10
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho