Individual
MARK A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
530 BIRCH ST, JUNCTION CITY, OR 97448-1524
(541) 998-2395
Mailing address
25117 SW PARKWAY AVE, SUITE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
240953
OR
Other
Enumeration date
11/30/2012
Last updated
05/29/2015
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