Individual
MR. DAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4455 NE HIGHWAY 20, CORVALLIS, OR 97330-9695
(541) 758-5900
Mailing address
475 SE PARK AVE, CORVALLIS, OR 97333-2145
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7007129
OR
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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