Individual
MR. LORENZO JOHNSON V
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS QMHA
Contact information
Practice address
8453 SW 30TH AVE, PORTLAND, OR 97219-8800
(503) 283-3763
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
372600000X
Adult Companion
—
—
Other
Enumeration date
02/01/2007
Last updated
04/23/2008
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