Individual
ERICA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
24076 SE STARK ST., GRESHAM, OR 97030
(503) 491-1666
Mailing address
24076 SE STARK ST., GRESHAM, OR 97030
(503) 491-1666
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
61214
OR
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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