Organization
LIFEWORKS NORTHWEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS BONNIE RENEE JOHNSON (CERTIFIED RECOVERY MENTOR)
(503) 282-3296
Entity
Organization
Contact information
Practice address
4941 NE 17TH AVE, PORTLAND, OR 97211-5709
(503) 645-3581
Mailing address
4838 NE 29TH AVE, PORTLAND, OR 97211-6359
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/26/2015
Last updated
08/26/2015
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