Most Relevant Information
Provider Data
| NPI Number: | 1003242173 |
| Provider Name: | HEATHER IRENE JOHNSON MSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/20/2013 |
| Last Updated: | 06/16/2021 |
Provider Practice Location
621 W MADRONE ST
ROSEBURG
OR
974703090
Practice Location Phone/Fax
| Phone: | 5414403532 |
| Fax: | 5414403554 |
Provider Mailing Location
PO BOX 1121
ROSEBURG
OR
974700254
Provider Mailing Phone/Fax
| Phone: | 5414403532 |
| Fax: | 5414403554 |