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Individual

LAUREL JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2875 NW STUCKI AVE, HILLSBORO, OR 97124-5806
(971) 310-1000
Mailing address
3615 NE SANDY BLVD, PORTLAND, OR 97232-1962
(503) 201-0507

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M4881
OR

Other

Enumeration date
10/19/2015
Last updated
10/19/2015
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