Individual
CHARLES EDWARD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II
Contact information
Practice address
2035 DAVCOR ST SE, SALEM, OR 97302-1595
(503) 576-4684
(503) 361-2688
Mailing address
2035 DAVCOR ST SE, SALEM, OR 97302-1595
(503) 576-4684
(503) 361-2688
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10-P-16
OR
Other
Enumeration date
09/02/2015
Last updated
09/02/2015
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