Provider Demographics
NPI:1821242264
Name:JOHNSON, JULIE ANN (RPH)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30300 SW BOONES FERRY RD
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-6889
Mailing Address - Country:US
Mailing Address - Phone:503-570-3533
Mailing Address - Fax:
Practice Address - Street 1:1840 PORTLAND RD
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1847
Practice Address - Country:US
Practice Address - Phone:503-538-9360
Practice Address - Fax:503-538-9261
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10392183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist