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Individual

MISS KRISTINE JUNE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
4115 SE HAGER LN, MILWAUKIE, OR 97267-2925
(503) 654-7115
Mailing address
14065 SE DOUGLAS FIR CT, MILWAUKIE, OR 97267-1525
(503) 653-1090

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
095000661RN
OR

Other

Enumeration date
09/24/2018
Last updated
09/24/2018
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