Lyndon George Johansen (NPI# 1306820402, PAC ID# 4688719420) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PODIATRY.
Nation Provider ID (NPI) | 1306820402 |
PAC ID by PECOS | 4688719420 |
Professional Enrollment ID | I20100304000840 |
Full Name | Lyndon George Johansen |
Address |
12658 Se Stark St Plaza 125 Portland OR 97233-1058 |
Gender | M |
Medical School | CALIFORNIA COLLEGE PODIATRIC MEDICINE |
Graduation Year | 1990 |
Primary Specialty | PODIATRY |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
380060 | ADVENTIST MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
12658 Se Stark St, Plaza 125, Portland, OR 97233-1058 |
Street Address |
12658 SE STARK ST PLAZA 125 |
City | PORTLAND |
State | OR |
Zip | 97233-1058 |
Name | Specialty | Organization | Address |
---|---|---|---|
Nanette G Zunkel | Nurse Practitioner | The Native American Rehabilitation Assoc of The Northwest Inc. | 12360 E Burnside St, Portland, OR 97233-1042 |
Artice E Geary | Clinical Social Worker | The Native American Rehabilitation Assoc of The Northwest Inc. | 12360 E Burnside St, Portland, OR 97233-1042 |
Judy Ann Hart | Undefined Physician Type (specify) | The Native American Rehabilitation Assoc of The Northwest Inc. | 12360 E Burnside St, Portland, OR 97233-1042 |
Jennifer J O' Donnell | Nurse Practitioner | Crm Physicians LLC | 12441 Se Stark St, Portland, OR 97233-1053 |
Ilene J Schechter | Psychologist, Clinical | Western Psychological and Counseling Services PC | 12636 Se Stark St Plaza 125 Bldg J, Portland, OR 97233-1058 |
Timothy M Brown | Dermatology | Timothy M. Brown, M.d., P.C. | 12612 Se Stark St, Portland, OR 97233-1058 |
Amy E Berg | Nurse Practitioner | Western Psychological and Counseling Services PC | 12636 Se Stark St Plaza 125 Bldg J, Portland, OR 97233-1058 |
Christine L Chatman | Clinical Social Worker | Western Psychological and Counseling Services PC | 12636 Se Stark St Plaza 125 Bldg J, Portland, OR 97233-1058 |
Frances V Verzosa | General Practice | 12770 Se Stark St Bldg C, Portland, OR 97233-1539 | |
Robert C Sayson | Internal Medicine | 18000 Se Stark St, Gresham, OR 97233-4828 | |
Find all physicians in zip 97233 |
City | PORTLAND |
Zip Code | 97233 |
Specialty | PODIATRY |
City + Specialty | PORTLAND + PODIATRY |
Please comment or provide details below to improve the information on Lyndon George Johansen.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.