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General NPI Number Information
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NPI Number | 1659363190
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Entity Type | Individual
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Provider Name | JOSHUA LAURENCE JOHNSON MD
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Gender | Male
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Dates
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Enumeration Date | 08/19/2005
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 1003 PROVIDENCE DR SUITE 210
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City | NEWBERG
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State | OR
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Zip | 97132-7521
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Country | US
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Telephone | 503-537-5900
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Fax | 503-537-5959
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Provider Business Mailing Address
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Address Line | PO BOX 3158
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City | PORTLAND
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State | OR
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Zip | 97208-3158
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD476319
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 87993
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME14804
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 91890
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License Number State | MT
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 21543
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License Number State | NH
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Taxonomy #6
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD23516
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License Number State | OR
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