Individual
DEZMOREE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CMHC
Contact information
Practice address
12511 SW 68TH AVE, SUITE 100, PORTLAND, OR 97223-8297
(503) 975-3379
Mailing address
12511 SW 68TH AVE, SUITE 100, PORTLAND, OR 97223-8297
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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