Individual
AMANDA JOHNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1040 NW 22ND AVE BLDG 2, SUITE 520, PORTLAND, OR 97210-3057
(503) 413-7557
(503) 413-6547
Mailing address
1040 NW 22ND AVE BLDG 2, SUITE 520, PORTLAND, OR 97210-3057
(503) 413-7557
(503) 413-6547
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
OR
Other
Enumeration date
08/26/2015
Last updated
08/26/2015
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