Individual
ADAM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II
Contact information
Practice address
518 SW 3RD, CORVALLIS, OR 97333
(541) 738-6832
Mailing address
518 SW 3RD ST, CORVALLIS, OR 97333-4439
(541) 738-6832
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
930931684
—
OR
Enumeration date
08/16/2017
Last updated
07/21/2022
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