IndividualActive
Ben Johnson, PA-C
NPI 1720152465 · Medical Physician Assistant · Phoenix, OR
Provider details
- NPI number
- 1720152465
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- Yes
- License
- PA00825 (OR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
205 N Phoenix Rd Ste 430
Phoenix, OR 97535-9108
Phone: (541) 778-4517
Fax: (541) 833-0995
Approximate (ZIP-level) locationGet directions
Mailing address
205 N Phoenix Rd Ste 430
Phoenix, OR 97535-9108
Registry dates
- Enumerated
- 2006-11-17
- Last updated
- 2024-02-09
- Certified
- 2024-02-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.