Individual
MR. MATT ALLEN JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, CADC II
Contact information
Practice address
722 N SUMNER ST, PORTLAND, OR 97217-2641
(719) 319-3649
Mailing address
8004 N INTERSTATE AVE, PORTLAND, OR 97217-6631
(971) 319-3649
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10-03-45U
OR
Other
Enumeration date
11/16/2011
Last updated
04/26/2024
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