MS. Mallory Johnson, PEDIATRICNP
MS. Mallory Johnson, PEDIATRICNP is a Pediatric Nurse Practitioner in Portland, Oregon. Practices as a sole proprietor. Licensed in Oregon.
- Licensed in
- OR
- In the registry since
- 2008
Practice location Address checks out
11790 SW Barnes Rd Blg A Ste 140Portland, OR 97225
Phone: (503) 643-2100
Fax: (503) 643-7300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Pediatric Nurse Practitioner (primary) | Taxonomy 363LP0200X · Licence 200850163NP (OR) |
|---|
Record details
| NPI number | 1265699508 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | PEDIATRICNP |
| Sole proprietor | Yes |
| NPI enumerated | May 22, 2008 |
| Last updated in NPPES | October 18, 2021 |
| Certification date | October 18, 2021 |
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