JOHNIE LYNN BRADFORD

PORTLAND, OR
NPI1326307000
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2012-05-15
Last Update Date2012-05-15
Business Address
Mr. JOHNIE LYNN BRADFORD
14600 NW CORNELL RD
PORTLAND, OR 97229-5442
Phone number: 503-645-3581
Mailing Address
Mr. JOHNIE LYNN BRADFORD
4207 N KERBY AVE
PORTLAND, OR 97217-3035
Phone number: 503-388-0697