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General NPI Number Information
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NPI Number | 1346911583
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Entity Type | Individual
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Provider Name | ANNMARIE LOUISE JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 09/27/2021
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 5520 S MACADAM AVE STE 260
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City | PORTLAND
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State | OR
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Zip | 97239-3741
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Country | US
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Telephone | 707-696-2071
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Fax |
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Provider Business Mailing Address
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Address Line | 5520 S MACADAM AVE STE 260
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City | PORTLAND
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State | OR
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Zip | 97239-3741
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C6345
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License Number State | OR
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