Provider Demographics
NPI:1386865061
Name:JOHNSON, ROBERT ARNOLD (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ARNOLD
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 S 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-3037
Mailing Address - Country:US
Mailing Address - Phone:509-301-6384
Mailing Address - Fax:509-593-4789
Practice Address - Street 1:362 S 3RD AVE
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-3037
Practice Address - Country:US
Practice Address - Phone:509-301-6384
Practice Address - Fax:509-593-4789
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000212142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry