Provider Demographics
NPI:1134211758
Name:JOHNSON, CLAUDIA RENEE (LMFT)
Entity type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:RENEE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 SW MACADAM
Mailing Address - Street 2:#100D
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239
Mailing Address - Country:US
Mailing Address - Phone:503-478-0667
Mailing Address - Fax:503-452-4405
Practice Address - Street 1:4700 SW MACADAM
Practice Address - Street 2:#100D
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239
Practice Address - Country:US
Practice Address - Phone:503-478-0667
Practice Address - Fax:503-452-4405
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT0228103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist