IndividualActive
C Johnson, PA-C
NPI 1770529919 · Physician Assistant · Lebanon, OR
Provider details
- NPI number
- 1770529919
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA00501 (OR)
Practice location
325 Park St
Lebanon, OR 97355-4229
Phone: (541) 451-7200
Fax: (541) 451-7229
Mailing address
325 Park St
Lebanon, OR 97355-4229
Registry dates
- Enumerated
- 2006-06-22
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.