Provider Demographics
NPI:1770561573
Name:JOHNSON, LORI S
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:S
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GLOBALMED
Other - Middle Name:SPECIALTY
Other - Last Name:MEDICAL EQUIPMENT INC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1159 SUDDEN VLY
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-4830
Mailing Address - Country:US
Mailing Address - Phone:360-756-9716
Mailing Address - Fax:360-527-8648
Practice Address - Street 1:7 HARBORVIEW CIRCLE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229
Practice Address - Country:US
Practice Address - Phone:360-756-9716
Practice Address - Fax:360-527-8648
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5055680001Medicare ID - Type UnspecifiedDURABLE MEDICAL EQUIPMENT