Individual
DR. GORDON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
24988 SE STARK ST, GRESHAM, OR 97030-8324
(503) 331-2376
Mailing address
3465 NE 36TH AVE, PORTLAND, OR 97212-2756
(503) 331-2376
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
MD19750
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150252
—
OR
Enumeration date
02/15/2006
Last updated
07/08/2007
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