Individual
JOHN JOSEPH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MFT
Contact information
Practice address
107 E MAIN ST STE 29, MEDFORD, OR 97501
(541) 201-2692
Mailing address
777 NORTHWOOD ST APT 12, MEDFORD, OR 97504-6548
(541) 201-2692
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T1009
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500698279
—
OR
Enumeration date
01/05/2011
Last updated
11/16/2018
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