Individual
CHRISTOPHER DAVID JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
986 SE UGLOW STREET, DALLAS, OR 97338
(503) 623-3538
(503) 623-8112
Mailing address
986 SE UGLOW STREET, DALLAS, OR 97338
(503) 623-3538
(503) 623-8112
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2925ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212606
EYE MED VISION INSURANCE
—
05
—
298499
—
OR
01
—
DC7770
MEDICARE RAILROAD
—
Enumeration date
09/07/2006
Last updated
07/08/2007
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