Individual
KARLA BETH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
980 N HAWTHORNE CT, CANBY, OR 97013-2737
(971) 322-9656
Mailing address
980 N HAWTHORNE CT, CANBY, OR 97013-2737
(971) 322-9656
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12209
OR
Other
Enumeration date
12/31/2008
Last updated
12/31/2008
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