Johnson, Gordon
Johnson, Gordon is an individual health care provider with primary practice located at 24988 Se Stark St , Gresham OR 97030-8324. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hospitalist, which is considered as his primary health care specialty. Johnson, Gordon can be contacted via phone (503) 331-2376.Contact Information
Primary practice address
24988 Se Stark St
Gresham OR 97030-8324
Phone: (503) 331-2376
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | MD19750 | Oregon |
Profile Details
| NPI number | 1235103276 |
|---|---|
| LBN Legal business name | Johnson, Gordon |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 15th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235103276 | NPPES |
| Oregon | MEDICAID | 150252 |
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