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1275076754
LATIA JOHNSON
PORTLAND, OR
NPI
1275076754
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2016-12-01
Last Update Date
2018-05-23
Business Address
LATIA JOHNSON
14600 NW CORNELL RD
PORTLAND, OR 97229
Phone number: 503-645-3581
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Mailing Address
LATIA JOHNSON
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: 503-238-0769
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