Individual
NATHALIE GEORGE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1130 NW 22ND AVE, SUITE 500, PORTLAND, OR 97210-2900
(503) 229-7431
(503) 292-1433
Mailing address
9155 SW BARNES RD, SUITE 830, PORTLAND, OR 97225-6625
(503) 229-7431
(503) 292-1433
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD17901
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044532
—
OR
Enumeration date
07/26/2006
Last updated
05/23/2008
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