Individual
MR. JOHNNY CORRACE WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.S.W.
Contact information
Practice address
10163 SE SUNNYSIDE RD STE 490, CLACKAMAS, OR 97015-5720
(503) 653-3451
Mailing address
PO BOX 1612, CLACKAMAS, OR 97015-1612
(503) 762-1866
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
001581
OR
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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