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1356064901
GRACE OLIVIA JOHNSON
PORTLAND, OR
NPI
1356064901
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2022-09-20
Last Update Date
2022-09-20
Business Address
GRACE OLIVIA JOHNSON
4212 SE DIVISION ST STE 100
PORTLAND, OR 97206-1680
Phone number: 503-238-0705
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Mailing Address
GRACE OLIVIA JOHNSON
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: 503-238-0769
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