Lyndon George Johansen


Address: 12658 Se Stark St, Plaza 125, Portland, OR 97233-1058

Lyndon George Johansen (NPI# 1306820402, PAC ID# 4688719420) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PODIATRY.

Physician Overview

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

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
380060 ADVENTIST MEDICAL CENTER

Other Locations

Address Phone Organization
12658 Se Stark St, Plaza 125, Portland, OR 97233-1058

Organization Information

Office Location

Street Address 12658 SE STARK ST
PLAZA 125
City PORTLAND
State OR
Zip 97233-1058

Physicians in the same zip code

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

Competitor

Search similar physicians

City PORTLAND
Zip Code 97233
Specialty PODIATRY
City + Specialty PORTLAND + PODIATRY

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Dataset Information

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.

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