Individual
PAUL W JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2222 NW LOVEJOY ST, STE 522, PORTLAND, OR 97210-3033
(503) 810-6555
(503) 286-7939
Mailing address
3439 NE SANDY BLVD, # 234, PORTLAND, OR 97232-1959
(503) 978-0178
(503) 286-7939
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
DO28084
OR
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
DO28084
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8467474
—
WA
Enumeration date
08/31/2006
Last updated
12/28/2016
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