MARK RONALD JOHANSEN (NPI# 1255680831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255680831 |
Entity Type | Individual |
Full Name | MARK RONALD JOHANSEN |
Credential | D.C. |
Practice Address |
12762 Se Stark St Plaza 125 Bldg. D Portland OR 97233-1539 |
Mailing Address |
14661 Se 172nd Ave Clackamas OR 97015-7771 |
Practice Telephone | 5032557746 |
Mailing Telephone | 5039985314 |
Enumeration Date | 2012-08-29 |
Last Update Date | 2012-09-04 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 111N00000X | Chiropractor | 5072 | OR | Chiropractic Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720066707 | Mark R Johansen | Physical Medicine & Rehabilitation | 3425 S Clarkson St, Englewood, CO 80113-2811 | 2006-01-09 |
1932257979 | Mark C. Johansen | Family Medicine | 10800 Magnolia Ave, Riverside, CA 92505-3043 | 2007-01-08 |
Street Address |
12762 SE STARK ST PLAZA 125 BLDG. D |
City | PORTLAND |
State | OR |
Zip Code | 97233-1539 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043301088 | James Lee Andrews | Chiropractor | 12762 Se Stark St, Plaza 125, Bldg D, Portland, OR 97233-1539 | 2006-09-27 |
1235302795 | Chiropractic Life Center PC | Chiropractor | 12762 Se Stark St, Plaza 125, Bldg D, Portland, OR 97233-1539 | 2008-04-04 |
1043302409 | Ronald R Johansen | Chiropractor | 12762 Se Stark St, Plaza 125 Bldg D, Portland, OR 97233-1539 | 2006-09-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205448164 | Moore Therapy Services, LLC | Behavioral Analyst | 2053 Se 181st Ave, Portland, OR 97233 | 2020-08-20 |
1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
1427573443 | Sunshine Ahc | In Home Supportive Care | 2217 Se 156th Ave, Portland, OR 97233 | 2017-08-10 |
1538609433 | Nathaniel Davis Jr. | Counselor | 8915 Se Center St, Tigard, OR 97233 | 2017-02-27 |
1154878627 | Oregon Outreach Inc | Case Management | 1740 South East 139th Avenue, Portland, OR 97233 | 2016-09-01 |
1023461019 | Julianne Baltzley | Counselor | 2409 Se 149th Avenue, Portland, OR 97233 | 2016-07-14 |
1710332143 | Emma Slater | Counselor | 12360 Se Burnside, Portland, OR 97233 | 2016-05-04 |
1245621952 | Gregory Brett Bledsoe | Counselor | 1427 Se 182nd Ave., Portland, OR 97233 | 2015-02-17 |
1396149852 | Jacqueline Bension | Counselor | 1705 Se 122nd Ave, Portland, OR 97233 | 2014-10-13 |
1700206950 | Olga I Zlatova I | Dental Hygienist | 325 Se 154th Ave, Portland, OR 97233 | 2014-04-25 |
Find all providers in zip 97233 |
Taxonomy Code | 111N00000X |
Grouping | Chiropractic Providers |
Classification | Chiropractor |
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700486958 | Amy Elizabeth Goebel | Chiropractor | 5103 Se Stark St Apt B, Portland, OR 97215-1764 | 2020-10-27 |
1003423914 | Evergreen Chiropractic PC | Chiropractor | 7145 Sw Varns St Ste 203, Portland, OR 97223-8168 | 2020-09-24 |
1750993283 | University of Western States Healthcare Inc | Chiropractor | 8000 Ne Tillamook St, Portland, OR 97213-6655 | 2020-08-17 |
1518587989 | Kristy Pearl Arneson | Chiropractor | 3715 Se Cesar E Chavez Blvd, Portland, OR 97202-1704 | 2020-04-25 |
1770102956 | Behireta Corbadzic | Chiropractor | 12923 Se Foster Rd Unit G703, Portland, OR 97236-4702 | 2020-04-08 |
1134754427 | Bonnie Anderson | Chiropractor | 3539 N Williams Ave Ste 202a, Portland, OR 97227-1437 | 2020-03-06 |
1629601372 | Megan Adele Robles | Chiropractor | 2100 Ne Broadway St Ste 255, Portland, OR 97232-1544 | 2020-02-20 |
1306479472 | Naomi M Enos-burles | Chiropractor | 7332 Sw 13th Dr Apt A, Portland, OR 97219-2089 | 2020-02-18 |
1184256927 | Michael Nicosia | Chiropractor | 207 Santa Monica St, Portland, TX 78374-2645 | 2020-02-10 |
1942832258 | Tracy Yvonne Still | Chiropractor | 3905b Ne Grand Ave Unit B, Portland, OR 97212-1107 | 2020-02-05 |
Find all providers in PORTLAND |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.