# DEBORAH M JOHNSON MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114292034
- **Authorized official:** DR. DEBORAH M JOHNSON (OWNER)
- **Authorized official phone:** (503) 585-9695

## Contact information

- **Practice address:** 1395 LIBERTY ST SE, SALEM, OR 97302-4276
- **Practice address phone:** (503) 585-9695
- **Practice address fax:** (503) 581-3960
- **Mailing address:** 1395 LIBERTY ST SE, SALEM, OR 97302-4276
- **Mailing address phone:** (503) 585-9695
- **Mailing address fax:** (503) 581-3960

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | MD16845 | OR | Yes |

## Other

- **Enumeration date:** 03/09/2012
- **Last updated:** 10/23/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 022538 | — | OR |