| NPI | 1174763064 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2009-03-05 |
| Last Updated | 2021-07-07 |
| Mailing Address | 3181 Sw Sam Jackson Park Rd Portland, OR 97239-3011 United States Phone: (503) 418-4500 | Fax: (503) 494-1678 📍 View Map |
| Primary Practice Address | 3181 Sw Sam Jackson Park Rd Portland, OR 97239-3011 United States Phone: (503) 418-4500 | Fax: (503) 494-1678 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | WA | 8551319 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 207V00000X – Obstetrics & Gynecology | OH | BS361734183369 |
| No | 207V00000X – Obstetrics & Gynecology | WA | OP60090125 |
| Yes | 207V00000X – Obstetrics & Gynecology | OR | DO203473 |
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About NPI 1174763064
Jil M Johnson D.O. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1174763064. The primary specialty listed is Obstetrics & Gynecology. The provider is located in Portland, OR. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2009-03-05. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1174763064?
NPI 1174763064 belongs to Jil M Johnson D.O., a Obstetrics & Gynecology in Portland, OR. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1174763064 active?
The current status of NPI 1174763064 in the NPPES registry is Active. The record was last updated on 2021-07-07.
What specialty is NPI 1174763064?
NPI 1174763064 is classified under the taxonomy Obstetrics & Gynecology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1174763064?
You can verify NPI 1174763064 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1174763064?
The primary practice address on file for NPI 1174763064 is 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1174763064 issued?
NPI 1174763064 was first issued (enumerated) on 2009-03-05. The NPPES record was last updated on 2021-07-07.
Practice Location Map
Jil M Johnson is located at 3181 Sw Sam Jackson Park Rd, Portland, OR. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Jil M Johnson. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1174763064. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Obstetrics & Gynecology | BS361734183369 | OH |
| Obstetrics & Gynecology | OP60090125 | WA |
| Obstetrics & Gynecology | DO203473 | OR |