Individual
KORTNIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SDH
Contact information
Practice address
17030 SW ROCKY RAMBLE LN, SHERWOOD, OR 97140-9215
(503) 928-0445
Mailing address
17030 SW ROCKY RAMBLE LN, SHERWOOD, OR 97140-9215
(503) 928-0445
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/30/2022
Last updated
11/30/2022
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