LYNDON G JOHANSEN (NPI# 1306820402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306820402 |
| Entity Type | Individual |
| Full Name | LYNDON G JOHANSEN |
| Credential | DPM |
| Practice Address |
12658 Se Stark St Portland OR 97233-1058 |
| Practice Telephone | 5032564018 |
| Practice Fax Number | 5032566298 |
| Mailing Telephone | 5032564018 |
| Mailing Fax Number | 5032566298 |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2013-01-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | DP00230 | OR | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 045653 | 05 |
| Street Address |
12658 SE STARK ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97233-1058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093993453 | Lyndon G Johansen Dpm PC | Clinic/Center | 12658 Se Stark St, Portland, OR 97233-1058 | 2008-02-07 |
| 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 | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033560867 | John M Barnes Dpm LLC | Podiatrist | 9615 Nw Randall Ln, Portland, OR 97229-5294 | 2016-06-22 |
| 1619338829 | Cara Beach | Podiatrist | 9900 Sw Hall Blvd Ste 100, Portland, OR 97223-5838 | 2016-03-15 |
| 1265743090 | Nanjin Jasmine Park | Podiatrist | 5311 Sw Baird St, Portland, OR 97219-5023 | 2010-06-26 |
| 1538339395 | Joseph Michael Mozena | Podiatrist | 2227 Ne Hancock St, Portland, OR 97212-4873 | 2008-03-08 |
| 1245443100 | Daniel L Nusser | Podiatrist | 2809 Ne Broadway, Portland, OR 97232 | 2007-05-08 |
| 1114048667 | Dr John D Mozena Dpm PC | Podiatrist | 8305 Se Monterey Ave Ste 101, Portland, OR 97266-7728 | 2007-04-03 |
| 1124116231 | Ray A Mcclanahan | Podiatrist | 725 Nw 19th Ave, Portland, OR 97209 | 2006-10-11 |
| 1942392113 | John M Barnes | Podiatrist | 506 Ne 49th Ave, Portland, OR 97213-2928 | 2006-09-28 |
| 1427150028 | Christopher S. Seuferling Dpm PC | Podiatrist | 7940 Se Division St, Suite E, Portland, OR 97206-1046 | 2006-09-03 |
| 1598867186 | Almira Ko | Podiatrist | 3586 Nw 112th Pl, Portland, OR 97229-4585 | 2006-09-02 |
| 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.