Individual
GREGORY W JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, AGACNP-BC
Contact information
Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-2906
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
10003142
OR
363L00000X
Nurse Practitioner
20652
TN
363LA2100X
Acute Care Nurse Practitioner
Primary
10003142
OR
363LA2100X
Acute Care Nurse Practitioner
20652
TN
363LF0000X
Family Nurse Practitioner
10003142
OR
363LG0600X
Gerontology Nurse Practitioner
10003142
OR
364SA2200X
Adult Health Clinical Nurse Specialist
20652
TN
Other
Enumeration date
09/15/2018
Last updated
06/08/2023
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