Individual
MR. KENNETH R JOHNSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
101YM0800X.
Contact information
Practice address
182 SW ACADEMY ST, DALLAS, OR 97338-1996
(503) 623-9289
Mailing address
605 SE JACK AVE, MCMINNVILLE, OR 97128-5345
(971) 237-8337
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
Other
Enumeration date
02/27/2026
Last updated
02/27/2026
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