Individual
CHASE ALEXANDER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
525 N SANTIAM HWY, LEBANON, OR 97355-4363
(541) 258-2101
Mailing address
PO BOX 1193, CORVALLIS, OR 97339-1193
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD210465
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2019
Last updated
10/28/2022
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