Individual
MISS TIBITHA JANE JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
3600 N INTERSTATE AVE, PORTLAND, OR 97227-1106
(503) 249-3429
Mailing address
2426 SE 157TH AVE, PORTLAND, OR 97233-3710
(503) 761-2329
Taxonomy
Speciality
Code
Description
License number
State
156FC0800X
Contact Lens Technician/Technologist
Primary
—
—
156FX1800X
Optician
D2024
WA
Other
Enumeration date
10/06/2006
Last updated
09/11/2025
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