Individual
MR. ANDREW ROBERT JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPAS, PA-C
Contact information
Practice address
3181 SW SAM JACKSON PARK RD # L-605, PORTLAND, OR 97239-3011
(503) 494-2265
(503) 494-7664
Mailing address
3181 SW SAM JACKSON PARK RD # L-605, PORTLAND, OR 97239-3011
(503) 494-2265
(503) 494-7664
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01300
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508069980
NPI
OR
Enumeration date
06/06/2007
Last updated
05/04/2015
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