Provider Demographics
NPI:1972996874
Name:JOHNSTON, KARI (DC)
Entity Type:Individual
Prefix:DR
First Name:KARI
Middle Name:
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1167 NW WALLULA AVE
Mailing Address - Street 2:#316
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-3666
Mailing Address - Country:US
Mailing Address - Phone:785-527-3590
Mailing Address - Fax:
Practice Address - Street 1:1167 NW WALLULA AVENUE
Practice Address - Street 2:#316
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030
Practice Address - Country:US
Practice Address - Phone:785-527-3590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60533870111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor