Individual
MRS. JESSICA GRACE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, UHS-8L, PORTLAND, OR 97239-3011
(503) 494-4382
Mailing address
3181 SW SAM JACKSON PARK RD, UHS-8L, PORTLAND, OR 97239-3011
(503) 494-4382
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L5763
OR
Other
Enumeration date
08/18/2009
Last updated
12/17/2015
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