Individual
GLENN DARRELL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
211 NE 18TH AVE, PORTLAND, OR 97232-2822
(503) 747-0404
Mailing address
4205 SE 180TH CT, VANCOUVER, WA 98683-8298
(360) 718-0173
(360) 718-0173
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/11/2025
Last updated
06/11/2025
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