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1760188429
WALTER MALCOLM JOHNSON
WHITE CITY, OR
NPI
1760188429
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-02-03
Last Update Date
2023-02-03
Business Address
WALTER MALCOLM JOHNSON
8495 CRATER LAKE HWY
WHITE CITY, OR 97503-3011
Phone number: 541-826-2111
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Mailing Address
WALTER MALCOLM JOHNSON
8495 CRATER LAKE HWY
WHITE CITY, OR 97503-3011
Phone number: 541-826-2111
Copy
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