Individual
AMANDA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1810 N 4TH ST, LAKEVIEW, OR 97630-1003
(541) 600-2535
(541) 325-4804
Mailing address
PO BOX 1168, LAKEVIEW, OR 97630-0046
(541) 600-2535
(541) 325-4804
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
202211248NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202211248NP-PP
NURSE PRACTITIONER
OR
Enumeration date
09/13/2022
Last updated
09/05/2025
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