Individual
SHANTAE RAE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DOULA
Contact information
Practice address
2971 SE 92ND AVE, PORTLAND, OR 97266-1429
(503) 477-3187
Mailing address
2971 SE 92ND AVENUE, PORTLAND, OR 97266
(503) 477-3187
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
OR
Other
Enumeration date
09/24/2010
Last updated
09/24/2010
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