MEDICARE: JOURNEY LYNN ARTIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	PA227617	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639911076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOURNEY LYNN ARTIS

Provider Business Mailing Address
First Line	:	619 NW 6TH AVE FL 5
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97209-3991
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5329 NE MARTIN LUTHER KING BLVD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97211-3237
Country	:	US
Telephone Number	:	503-988-5558
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2024
Last Update Date	:	03/10/2026

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Directions to “ JOURNEY LYNN ARTIS ” Practice Location

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