Healthcare Provider Details

I. General information

NPI: 1083710073
Provider Name (Legal Business Name): LANDON T HORNE M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 NE HOYT ST STE 340
PORTLAND OR
97213-2983
US

IV. Provider business mailing address

541 NE 20TH AVE STE 232
PORTLAND OR
97232-2862
US

V. Phone/Fax

Practice location:
  • Phone: 503-234-9861
  • Fax: 503-238-0873
Mailing address:
  • Phone: 503-963-2801
  • Fax: 503-963-2825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD25533
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD00040852
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberMD25533
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberMD00040852
License Number StateWA
# 5
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberMD225472
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: