Individual
BONNIE RENEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC1,
Contact information
Practice address
14600 NW CORNELL RD, PORTLAND, OR 97229
(503) 645-3581
Mailing address
14600 SW CORNELL, PORTLAND, OR 97229
(503) 645-3581
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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