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1952296675
GLENN DARRELL JOHNSON
PORTLAND, OR
NPI
1952296675
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2025-06-11
Last Update Date
2025-06-11
Business Address
GLENN DARRELL JOHNSON
211 NE 18TH AVE
PORTLAND, OR 97232-2822
Phone number: 503-747-0404
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Mailing Address
GLENN DARRELL JOHNSON
4205 SE 180TH CT
VANCOUVER, WA 98683-8298
Phone number: 360-718-0173
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