Individual
GINNIE LEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
16100 SW 72ND AVE, PORTLAND, OR 97224-7745
(800) 330-3665
Mailing address
PO BOX 230969, PORTLAND, OR 97281-0969
(800) 330-3665
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
10258
OR
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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