Individual
EVAN RIAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2236 SE BELMONT ST, PORTLAND, OR 97214-2817
(503) 445-7699
Mailing address
2236 SE BELMONT ST, PORTLAND, OR 97214-2817
(503) 445-7699
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201607493RN
OR
363LF0000X
Family Nurse Practitioner
Primary
201806939NP-PP
OR
Other
Enumeration date
08/21/2018
Last updated
09/22/2020
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