Individual
JACOB JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3925 SW 153RD DR, BEAVERTON, OR 97003-4166
(971) 727-8155
Mailing address
205 NW 16TH AVE APT 2, PORTLAND, OR 97209-2648
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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