Individual
JOHN HERNDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7772
(503) 418-9276
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7772
(503) 418-9276
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD218422
OR
2084N0400X
Neurology Physician
MED-PHYS-LIC-77300
MT
390200000X
Student in an Organized Health Care Education/Training Program
201814
NC
Other
Enumeration date
04/21/2014
Last updated
01/02/2024
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