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General NPI Number Information
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NPI Number | 1518929405
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Entity Type | Individual
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Provider Name | DEBRA F JOHNSON PNP
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Gender | Female
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 831 NW COUNCIL DR STE 125
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City | GRESHAM
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State | OR
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Zip | 97030-3794
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Country | US
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Telephone | 503-665-8176
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Fax | 503-665-8178
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Provider Business Mailing Address
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Address Line | 831 NW COUNCIL DR STE 125
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City | GRESHAM
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State | OR
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Zip | 97030-3794
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Country | US
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Telephone | 503-665-8176
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Fax | 503-665-8178
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | RN059093
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201601734NP-PP
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License Number State | OR
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