Individual
BROOKE E JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(971) 202-8400
(503) 239-8407
Mailing address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(971) 202-8400
(503) 239-8407
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101YM0800X
COUNSELOR MENTAL HEALTH
OR
Enumeration date
10/05/2018
Last updated
10/05/2018
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