Individual
FAYANNA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10615 SE CHERRY BLOSSOM DR STE 250, PORTLAND, OR 97216-3103
(971) 373-4041
Mailing address
8383 NE SANDY BLVD STE 440, PORTLAND, OR 97220-4986
(971) 373-4041
(971) 373-5285
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L7709
OR
Other
Enumeration date
05/17/2016
Last updated
05/14/2025
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