Individual
MRS. KELLI M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
(503) 570-3665
(503) 570-9155
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
781
NE
Other
Enumeration date
03/18/2021
Last updated
03/18/2021
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