Individual
DR. JIL M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-4500
(503) 494-1678
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-4500
(503) 494-1678
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
BS361734183369
OH
207V00000X
Obstetrics & Gynecology Physician
Primary
DO203473
OR
207V00000X
Obstetrics & Gynecology Physician
OP60090125
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8551319
—
WA
Enumeration date
03/05/2009
Last updated
07/07/2021
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