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Individual

LAUREL JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CSWA

Contact information

Practice address
2154 NE BROADWAY ST STE 110, PORTLAND, OR 97232-1561
(503) 473-2081
Mailing address
2154 NE BROADWAY ST STE 110, PORTLAND, OR 97232-1561
(503) 473-2081

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
A16501
OR
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
11/20/2009
Last updated
01/13/2026
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