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Individual

KARIN JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7201 NE GLISAN ST, PORTLAND, OR 97213-6369
(503) 999-8959
Mailing address
928 SE 49TH AVE APT 1, PORTLAND, OR 97215-2567
(310) 254-8442

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
21349
OR

Other

Enumeration date
02/11/2016
Last updated
02/11/2016
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