Organization
GENEVIEVE JOHNSON LAC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENEVIEVE LYNN JOHNSON L.AC. (MEMBER)
(503) 440-2942
Entity
Organization
Contact information
Practice address
240 SE 87TH AVE, PORTLAND, OR 97216-1528
(503) 440-2942
Mailing address
240 SE 87TH AVE, PORTLAND, OR 97216-1528
(503) 440-2942
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC01225
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500646474
—
OR
Enumeration date
05/11/2012
Last updated
02/05/2015
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