NPI 1629219613

Lorita Elaine Johnson, LMT

Practitioner Mechanotherapist Gresham, OR

Practice location

Address: 24850 SE Stark St STE 200, Gresham, OR 97030-8320
Phone: (971) 285-2905
Mailing address: PO Box 1615, Sandy, OR 97055-1615

Registered specialties

Mechanotherapist Primary

Other Service Providers Taxonomy 172M00000X Licence 6181 (OR)

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Registry record

NPI: 1629219613
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Mar 2009
Record last updated: 20 Mar 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.