Individual
PHILLIP JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10615 SE CHERRY BLOSSOM DR STE 250, PORTLAND, OR 97216-3103
(971) 373-4041
Mailing address
8383 NE SANDY BLVD STE 440, PORTLAND, OR 97220-4986
(971) 373-4041
(971) 373-5285
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/20/2022
Last updated
05/14/2025
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