Lyndon G Johansen, DPM

NPI #1306820402 in Portland, Oregon

Provider Information

NPI Number: 1306820402
Entity Type: Individual
Name: Lyndon G Johansen, DPM
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Podiatrist
Credential: DPM
Enumeration Date: Dec 1, 2005
Last Updated: Jan 2, 2013

Practice Location

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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