Tavis M Johansson, D.C.

NPI #1053756445 in Portland, Oregon

Provider Information

NPI Number: 1053756445
Entity Type: Individual
Name: Tavis M Johansson, D.C.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Chiropractor
Credential: D.C.
Enumeration Date: Apr 30, 2013
Last Updated: Apr 30, 2013

Practice Location

Address: 6018 SE STARK ST
Address 2: SUITE 103
City: Portland
State: Oregon
ZIP Code: 97215-1990
Phone: (503) 808-9145

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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