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Individual

LEE MICHAEL JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
800 MAIN AVE STE A, TILLAMOOK, OR 97141-3760
(503) 842-5568
Mailing address
800 MAIN AVE STE A, TILLAMOOK, OR 97141-3760
(503) 842-5568

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
2698
GA
152W00000X
Optometrist
Primary
AT-4289
OR

Other

Enumeration date
07/07/2011
Last updated
08/21/2022
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