Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dallisa Johnson, CPHT-ADV

Individual provider Pharmacy Technician · NPI 1417874066

Dallisa Johnson, CPHT-ADV is a Pharmacy Technician in Moscow, Idaho. Practices as a sole proprietor. Licensed in Idaho.

Licensed in
ID
In the registry since
2026

Practice location Address checks out

700 S Main St
Moscow, ID 83843-3046
Phone: (208) 883-6245
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacy Technician (primary) Taxonomy 183700000X · Licence CT1222 (ID)

Record details

NPI number1417874066
Entity typeIndividual (Type 1)
GenderFemale
Credentials CPHT-ADV
Sole proprietorYes
NPI enumeratedJuly 3, 2026
Last updated in NPPESJuly 3, 2026
Certification dateJuly 3, 2026
Mailing address517 Elm St # 194, Troy, ID 83871-0077

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