Individual
VICTORIA LYNNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2415 SE 43RD AVE, PORTLAND, OR 97206-1600
(503) 238-0705
Mailing address
12106 SE RIVER ROAD, APT 127, MILWAUKIE, OR 97222
(971) 221-7559
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
12/27/2007
Last updated
03/03/2008
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