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Individual

KEITH JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5 CENTERPOINTE DR, LAKE OSWEGO, OR 97035-8651
(503) 606-6355
(503) 404-4555
Mailing address
5 CENTERPOINTE DR STE 400, LAKE OSWEGO, OR 97035-8661
(503) 606-6635
(581) 333-1291

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
9601928-1205
UT
2084P0800X
Psychiatry Physician
Primary
MD187490
OR

Other

Enumeration date
04/10/2014
Last updated
02/24/2023
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