Individual
JUSTIN TYLER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
58646 MCNULTY WAY, SAINT HELENS, OR 97051-6210
(503) 397-5211
Mailing address
PO BOX 1234, SAINT HELENS, OR 97051-8234
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OR
Other
Enumeration date
11/07/2021
Last updated
11/07/2021
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