National Provider Identifier Database

LYNDON G JOHANSEN, DPM – NPI #1306820402
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.


Contact Information

LYNDON G JOHANSEN, DPM
12658 SE STARK ST
PORTLAND, OR97233-1058
Phone: 503-256-4018
Fax: 503-256-6298
Website:
Specialty Taxonomy Code
* Podiatrist 213E00000X

* Indicates primary specialty

NPI Profile & details for LYNDON G JOHANSEN

NPI Number 1306820402
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 12/01/2005
Last updated 01/02/2013 - About 13 years ago
Sole proprietor1 Yes
Identifiers
  • OR License #: DP00230
  • OR Medicaid: 045653
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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