Individual provider · Type 1 NPI
Kendall Amanda Johnson, PA-C
Surgical Physician Assistant · Lake Oswego, OR
NPI number
1962785212
Active
Practice location
4250 Mercantile Dr
Lake Oswego, OR 97035-2504
Mailing address
4250 Mercantile Dr Ste B
Lake Oswego, OR 97035-2504
Other practice locations
- 2695 SW Cedar Hills Blvd Ste 140, Beaverton, OR 97005-1415 · (503) 850-9950
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | PA229637 (OR) |
| Surgical Physician Assistant | 363AS0400X | AMD-617 (HI) |
Surgical Physician Assistant: Definition to come...
3 other providers at this address
Other surgical physician assistant providers in Lake Oswego
About NPI 1962785212
Kendall Amanda Johnson, PA-C's National Provider Identifier is 1962785212, issued on Sep 22, 2011. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Lake Oswego, OR. The record was last updated on Aug 30, 2026.