Individual
ANDREA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
9833 N PORTSMOUTH AVE, PORTLAND, OR 97203-1940
(503) 286-1015
Mailing address
9833 N PORTSMOUTH AVE, PORTLAND, OR 97203-1940
(503) 286-1015
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/01/2013
Last updated
07/13/2021
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