Provider Demographics
NPI:1548315161
Name:JOHNSON, SHERRI ANN (QMHA)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:ANN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 NE 181ST AVE # 216
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-6660
Mailing Address - Country:US
Mailing Address - Phone:503-236-2508
Mailing Address - Fax:
Practice Address - Street 1:465 NE 181ST AVE # 216
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-6660
Practice Address - Country:US
Practice Address - Phone:503-236-2508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171M00000XOther Service ProvidersCase Manager/Care Coordinator
Not Answered372600000XNursing Service Related ProvidersAdult Companion