Individual
MARK C. JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
14406 NE 20TH AVE, VANCOUVER, WA 98686-1448
(800) 813-2000
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2031
(800) 813-2000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A9549
CA
207Q00000X
Family Medicine Physician
Primary
OP60478179
WA
Other
Enumeration date
01/08/2007
Last updated
04/21/2026
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