Individual
ELYSE WALKER JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8924 N FISKE AVE, PORTLAND, OR 97203-3575
(503) 559-4956
Mailing address
8924 N FISKE AVE, PORTLAND, OR 97203-3575
(503) 559-4956
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/26/2023
Last updated
10/26/2023
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