Lyndon G Johansen
DPM | Podiatrist | 35+ years Exp
Medicare Enrolled
12658 Se Stark St, Portland
Oregon, 97233-1058
503-256-4018 503-256-6298
Maps & DirectionsLyndon G Johansen is a Portland, Oregon based podiatrist with 35 years of experience in Podiatry. He completed his graduation from California School Of Podiatric Medicine in 1990. He is also affiliated with hospitals like Adventist Health Portland. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Lyndon G Johansen for Podiatry is DP00230 in Oregon.
Lyndon G Johansen is qualified with a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. He diagnose and treat foot diseases and deformities. He can perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
Complete Profile:
Lyndon G Johansen speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Specialization: | Podiatry |
| Credentials: | DPM |
| Experience: | 35+ years |
| Medical School Attended: | California School Of Podiatric Medicine |
| Graduation Year: | 1990 |
| Gender: | Male |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 12658 Se Stark St, Portland,
Oregon, 97233-1058 |
| Phone: | 503-256-4018 |
| Fax: | 503-256-6298 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 4688719420 |
| Enrollment ID: | I20100304000840 |
| NPI Number: | 1306820402 |
| NPI Enumeration Date: | 01 Dec, 2005 |
| NPI Last Update On: | 02 Jan, 2013 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Lyndon G Johansen are as mentioned below.
| License Number | Specialization | State | Status | |
| DP00230 | Podiatry | Oregon | Primary | |
Hospital Affiliation:
Doctors are affiliated to many hospitals whom they worked with in the past or are presently working with. One surgeon can be affiliated to four to five hospitals at a time.
| Hospital Name (CCN) | State | Hospital Type |
| Adventist Health Portland (380060) | Portland, OR | Acute Care Hospital |
Other Medical Identifiers:
Other legacy medical identifiers associated with Lyndon G Johansen such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 045653 | Medicaid | Oregon | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 12658 Se Stark St,
Portland, Oregon |
| Zip: | 97233-1058 |
| Phone Number: | 503-256-4018 |
| Fax Number: | 503-256-6298 |
Patients can reach Lyndon G Johansen at
12658 Se Stark St, Portland, Oregon or can
call to book an appointment on 503-256-4018.
Comments/ Reviews:
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** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.