Individual
EMMALINE JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4101 NE DIVISION ST, GRESHAM, OR 97030-4617
(503) 666-6575
Mailing address
4101 NE DIVISION ST, GRESHAM, OR 97030-4617
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100598
OHP
—
Enumeration date
09/20/2021
Last updated
09/20/2021
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