MR. Anthony Lance Johnson, PA-C

NPI #1174136725 in Lake Oswego, Oregon

Provider Information

NPI Number: 1174136725
Entity Type: Individual
Name: MR. Anthony Lance Johnson, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Aug 24, 2020
Last Updated: Feb 8, 2022

Practice Location

Address: 4103 MERCANTILE DR
City: Lake Oswego
State: Oregon
ZIP Code: 97035-2556
Phone: (503) 850-9940

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary
Student in an Organized Health Care Education/Training Program	390200000X

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