Individual
DR. JASON ALAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1020 SW TAYLOR ST STE 245, PORTLAND, OR 97205-2507
(503) 853-4998
Mailing address
1020 SW TAYLOR ST STE 245, PORTLAND, OR 97205-2507
(503) 853-4998
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
08-08-25
OR
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
3055
OR
171M00000X
Case Manager/Care Coordinator
—
—
174400000X
Specialist
—
—
Other
Enumeration date
10/29/2007
Last updated
06/14/2023
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