Individual
DR. CLOTILDE AMELIA JOHNSON-BEALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H.
Contact information
Practice address
25050 SE STARK ST STE 300, GRESHAM, OR 97030-3388
(503) 667-8878
(503) 667-0310
Mailing address
25050 SE STARK ST STE 300, GRESHAM, OR 97030-3388
(503) 667-8878
(503) 667-0310
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD158570
OR
2080A0000X
Pediatric Adolescent Medicine Physician
MD158570
OR
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD60273531
WA
Other
Enumeration date
04/12/2008
Last updated
02/02/2026
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