Individual
JEFF JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6410 NE HALSEY ST, PORTLAND, OR 97213-4742
(503) 215-4663
Mailing address
2729 SE YAMHILL ST APT 2, PORTLAND, OR 97214-2983
(541) 350-4107
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/12/2020
Last updated
12/12/2020
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