IndividualActive
Nicholas Johantgen, PA-C
NPI 1851731152 · Medical Physician Assistant · Portland, OR
Provider details
- NPI number
- 1851731152
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- Yes
- License
- PA161672 (OR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(77/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
9155 Sw Barnes Rd
Suite 934
Portland, OR 97225-6625
Phone: (503) 229-7015
Street-level locationGet directions
Mailing address
1438 Sw College St
Portland, OR 97201-2500
Registry dates
- Enumerated
- 2013-07-01
- Last updated
- 2013-07-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.