Individual
JOAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3909 SE 70TH AVE, PORTLAND, OR 97206-2525
(503) 777-2278
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
11/22/2006
Last updated
01/28/2013
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