Individual
COURTNEY RENAE JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
305 S FIR ST, MEDFORD, OR 97501-3144
(541) 200-3000
Mailing address
600 MARY PL, MEDFORD, OR 97501-2348
(541) 973-7637
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
175T00000X
OR
Other
Enumeration date
05/20/2024
Last updated
05/20/2024
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