Individual
SUSAN C. JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1020 SW TAYLOR ST, SUITE 625, PORTLAND, OR 97205-2543
(503) 227-3713
Mailing address
1020 SW TAYLOR ST, SUITE 625, PORTLAND, OR 97205-2543
(503) 227-3713
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0842
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004478
—
OR
Enumeration date
10/19/2006
Last updated
07/09/2007
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