Individual
MONICA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4673
(503) 494-4982
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4673
(503) 494-4982
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD204036
OR
390200000X
Student in an Organized Health Care Education/Training Program
PG177462
OR
Other
Enumeration date
05/23/2016
Last updated
06/15/2021
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