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1306820402
LYNDON G JOHANSEN
PORTLAND, OR
NPI
1306820402
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
213E00000X Podiatrist
(Licence: OR DP00230)
Enumeration Date
2005-12-01
Last Update Date
2013-01-02
Business Address
-- LYNDON G JOHANSEN DPM
12658 SE STARK ST
PORTLAND, OR 97233-1058
Phone number: 503-256-4018
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Mailing Address
-- LYNDON G JOHANSEN DPM
12658 SE STARK ST
PORTLAND, OR 97233-1058
Phone number: 503-256-4018
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