Individual ProviderElly Johanson RedfordCounselorBehavioral Health & Social Service ProvidersPractice Address1601 E Fourth Plain Blvd, Vancouver, WA 98661-3713(360) 334-5346PECOS EnrollmentBased on the most recent information from CMS, provider Elly Johanson Redford does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:04 AM.Profile DetailsProvider ID1821679432Provider TypeIndividualFull NameRedford, Elly JohansonGenderFemaleSole ProprietorYesEnumeration Date4/15/2021Last Updated4/15/2021Contact InformationPractice LocationPractice Address1601 E Fourth Plain Blvd, Vancouver, WA 98661-3713Phone(360) 334-5346FaxUnlisted FaxMailing LocationMailing Address4794 SE Ada Ln, Milwaukie, OR 97222-5372Phone(360) 334-5346FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer