Marshall Wallace Johnson
Peer Specialist in Klamath Falls, OR. Individual provider (NPI-1).
NPI number1982259669
StatusActive
Last updated in NPPESAug 11, 2020
Details
- NPI
- 1982259669
- Entity type
- Individual (NPI-1)
- Name
- Marshall Wallace Johnson
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 8, 2019
- Certification date
- Aug 11, 2020
- Last updated
- Aug 11, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | – | – | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Practice location
2210 N Eldorado AveKlamath Falls, OR 97601-6418
Phone 541-883-1030 · Fax 541-884-2338
Mailing address
2210 N Eldorado AveKlamath Falls, OR 97601-6418
Phone 541-883-1030 · Fax 541-884-2338
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All 173 Peer Specialist providers in Klamath Falls · All 2,330 providers in Klamath Falls
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