Lyndon G Johansen Dpm PC

NPI #1093993453 in Portland, Oregon

Provider Information

NPI Number
1093993453
Entity Type
Organization
Organization Name
Lyndon G Johansen Dpm PC
Primary Specialty
Clinic/Center - Podiatric
Enumeration Date
Feb 7, 2008
Last Updated
Oct 5, 2011

Practice Location

Address
12658 SE STARK ST
State
Oregon
ZIP Code
97233-1058
Phone
(503) 256-4018

Authorized Official

Name
LYNDON GEORGE JOHANSEN, D.P.M.
Title
OWNER
Phone
(503) 256-4018

Specialties & Taxonomy Codes

Specialty
Clinic/Center - PodiatricPodiatric

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