Individual provider · Type 1 NPI

Johanna Christine Provenzano

Adult Companion · Portland, OR

NPI number 1760820914 Active

Practice location

5023 NE Killingsworth St
Portland, OR 97218-1915

Call (503) 284-4249 Map

Mailing address

PO Box 8459
Portland, OR 97207-8459

Specialties and licenses

TaxonomyCodeLicense
Adult Companion Primary 372600000XNone listed

Adult Companion: An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care.

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About NPI 1760820914

Johanna Christine Provenzano's National Provider Identifier is 1760820914, issued on Jun 10, 2013. The primary taxonomy on file is Adult Companion (372600000X), and the practice location is in Portland, OR. The record was last updated on Jun 10, 2013.