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1417210675
KEITH D JOHNSON
PORTLAND, OR
NPI
1417210675
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP1600X Counselor, Pastoral
Enumeration Date
2012-06-21
Last Update Date
2012-06-21
Business Address
Mr. KEITH D JOHNSON MAED
3415 SE POWELL BLVD
PORTLAND, OR 97202-3371
Phone number: 503-445-0436
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Mailing Address
Mr. KEITH D JOHNSON MAED
3415 SE POWELL BLVD
PORTLAND, OR 97202-3371
Phone number:
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