Individual
JEANETTE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3990 ABBEY LN B-109, ASTORIA, OR 97103-2237
(503) 325-9076
(503) 325-1728
Mailing address
3990 ABBEY LN B-109, ASTORIA, OR 97103-2237
(503) 325-9076
(503) 325-1728
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1408
OR
Other
Enumeration date
07/26/2006
Last updated
07/09/2015
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