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DR. JAMES (JIM) CHARLES JOHNSON PH.D.

Clinical Neuropsychologist

Portland, Oregon

Provider NPI: 1497831713

Provider Information:
DR. JAMES (JIM) CHARLES JOHNSON PH.D.
Gender: M
Sole Proprietor


Practice Location:
516 SE 71ST AVE  PORTLAND, OR 97215 US
Tel: 503-252-3906  Fax: 503-252-5824

Business Mailing Address:
516 SE 71ST AVE  PORTLAND, OR 97215 US
Tel: 503-252-3906  Fax: 503-252-5824

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
OR0515

Other Provider Identifiers:

IssuerNumberStateType
PSYCHOLOGY LICENSE NUMBER0515OR01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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