Individual
DESIREE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7689 SW CAPITOL HWY, PORTLAND, OR 97219-2475
(503) 445-4433
(503) 445-4464
Mailing address
7105 SW GARDEN HOME RD APT 39, 7689 SW CAPITOL HWY, PORTLAND, OR 97223-9532
(503) 445-4433
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16182
OR
Other
Enumeration date
04/28/2011
Last updated
04/28/2011
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