Individual
JESSICA RENE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC 1
Contact information
Practice address
9570 SW BARBUR BLVD ACADIA NW, SUITE 100, PORTLAND, OR 97219
(503) 245-6262
Mailing address
12330 SE BUSH STREET, APT. 15, PORTLAND, OR 97236
(971) 206-1028
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/11/2021
Last updated
05/11/2021
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