Individual
LORITA ELAINE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
24850 SE STARK ST STE 200, GRESHAM, OR 97030-8320
(971) 285-2905
Mailing address
PO BOX 1615, SANDY, OR 97055-1615
(971) 285-2905
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
6181
OR
Other
Enumeration date
03/20/2009
Last updated
03/20/2009
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