Individual
PAMELA ROSE JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4585 SW 185TH AVE, ALOHA, OR 97078-1557
(503) 591-9280
Mailing address
4585 SW 185TH AVE, ALOHA, OR 97078-1557
(503) 591-9280
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
081001354RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
081001354RN
NURSING
OR
Enumeration date
06/02/2017
Last updated
07/21/2022
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