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1770001638
REGAN LYNN JOHNSON
PORTLAND, OR
NPI
1770001638
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Former Name
REGAN LYNN SHATTUCK-SMALLWOOD
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2017-08-31
Last Update Date
2017-08-31
Business Address
REGAN LYNN JOHNSON
10232 SE ANKENY ST APT C205
PORTLAND, OR 97216-4617
Phone number: 541-731-4123
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Mailing Address
REGAN LYNN JOHNSON
8915 SW CENTER ST
TIGARD, OR 97223-6307
Phone number: 503-501-5322
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