CHARLES EDWARD JOHNSON

SALEM, OR
NPI1720456171
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  10-P-16)
Enumeration Date2015-09-02
Last Update Date2015-09-02
Business Address
-- CHARLES EDWARD JOHNSON CADC II
2035 DAVCOR ST SE
SALEM, OR 97302-1595
Phone number: 503-576-4684
Mailing Address
-- CHARLES EDWARD JOHNSON CADC II
2035 DAVCOR ST SE
SALEM, OR 97302-1595
Phone number: 503-576-4684