Individual
ELIZABETH IRWIN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17360 HOLY NAMES DR, LAKE OSWEGO, OR 97034-5133
(503) 675-2004
Mailing address
7230 SW VIRGINIA AVE, PORTLAND, OR 97219-3037
(971) 404-6442
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
254224
OR
Other
Enumeration date
07/16/2008
Last updated
01/12/2011
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