Individual
AMELIA H JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300 N GRAHAM ST STE 125, PORTLAND, OR 97227-1683
(503) 528-0704
Mailing address
134 W CHRISFIELD DR, MERIDIAN, ID 83646-3255
(541) 232-1314
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA159647
OR
Other
Enumeration date
10/16/2012
Last updated
12/11/2019
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