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1720278310
CLARK MITCHELL JOHNSON
SAINT HELENS, OR
NPI
1720278310
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 101YAO4OOx)
Enumeration Date
2007-07-30
Last Update Date
2007-07-30
Business Address
Mr. CLARK MITCHELL JOHNSON B.S. CADC II
58646 MCNULTY WAY
SAINT HELENS, OR 97051-6210
Phone number: 503-397-5211
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Mailing Address
Mr. CLARK MITCHELL JOHNSON B.S. CADC II
58646 MCNULTY WAY
SAINT HELENS, OR 97051-6210
Phone number: 503-397-5211
Copy
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