Individual
JOAN M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
19250 SW 65TH AVE, MEDICAL PLAZA, SUITE 125, TUALATIN, OR 97062-7452
(503) 692-1817
(503) 692-1669
Mailing address
PO BOX 4037, PORTLAND, OR 97208-4037
(503) 413-4048
(503) 413-2910
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1069889
OR
Other
Enumeration date
01/12/2010
Last updated
11/30/2010
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