Individual
RAE S. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
452 WELCH ST, SILVERTON, OR 97381-1934
(503) 874-2454
(503) 779-2290
Mailing address
1475 MOUNT HOOD AVE, WOODBURN, OR 97071-9066
(971) 983-5260
(971) 983-5326
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
156400
OR
Other
Enumeration date
04/29/2010
Last updated
10/15/2020
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