Individual
ARETHA L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
9750 NE GLISAN ST, PORTLAND, OR 97220-4449
(503) 256-3920
Mailing address
9750 NE GLISAN ST, PORTLAND, OR 97220-4449
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
202109861LPN
OR
Other
Enumeration date
01/18/2023
Last updated
01/18/2023
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