Organization
ANJULI SHAH-JOHNSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANJULI SHAH-JOHNSON (OWNER/THERAPIST/BODYWORKER)
(773) 991-0103
Entity
Organization
Contact information
Practice address
1611 NE 16TH AVE, PORTLAND, OR 97232-1413
(773) 991-0103
Mailing address
1611 NE 16TH AVE, PORTLAND, OR 97232-1413
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
L5990
OR
Other
Enumeration date
01/20/2016
Last updated
01/20/2016
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