Individual
STEPHANIE MICHELE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, APRN, NP
Contact information
Practice address
3560 SE 79TH AVE, PORTLAND, OR 97206-2372
(503) 775-4414
Mailing address
2824 SE 74TH WAY, HILLSBORO, OR 97123-6620
(971) 732-6255
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
201800347NP-PP
OR
363LG0600X
Gerontology Nurse Practitioner
Primary
201800347NP-PP
OR
Other
Enumeration date
05/09/2018
Last updated
04/30/2025
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