Individual
CHELSEA MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1410 NE 106TH AVE, PORTLAND, OR 97220
(503) 460-0405
Mailing address
1410 NE 106TH AVE, PORTLAND, OR 97220-3934
(503) 460-0405
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201910074RN
OR
363LP2300X
Primary Care Nurse Practitioner
Primary
201910882NP-PP
OR
Other
Enumeration date
09/15/2022
Last updated
08/06/2023
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