Individual
SCOTTY A JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
738 NE DAVIS ST, PORTLAND, OR 97232-2931
(503) 233-6090
Mailing address
1206 SE 87TH AVE, PORTLAND, OR 97216-1704
(503) 498-0557
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/31/2020
Last updated
08/31/2020
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