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Organization
MINDFUL THERAPY PDX PC
Active
Organization
MINDFUL THERAPY PDX PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD L JOHNSON LPC (PRESIDENT)
(503) 734-0552
Entity
Organization
Contact information
Practice address
423 NE 60TH AVE, PORTLAND, OR 97213-3725
(503) 734-0552
Mailing address
636 N LOMBARD ST, PORTLAND, OR 97217-1576
(503) 734-0552
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/27/2023
Last updated
11/06/2023
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