Active NPI
Jason J Johnson, RN
- Administrator Registered Nurse
- Tualatin, OR
National Provider Identifier
1003316183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Administrator Registered Nurse
- License
- 2002409162RN
- Practice address
- 6464 SW Borland Rd Ste C1
Tualatin, OR 97062-8856 - Phone
- (503) 878-5412
- NPI assigned
- Feb 15, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Administrator Registered Nurse | 163WA2000X | 2002409162RN | OR | Primary |
Addresses
Primary practice location
6464 SW Borland Rd Ste C1
Tualatin, OR 97062-8856
Mailing address
6464 SW Borland Rd Ste C1
Tualatin, OR 97062-8856
Phone (503) 878-5412
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2002409162RN | OR | MD | Administrator Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518652800000",
"number": "1003316183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6464 SW BORLAND RD STE C1",
"city": "TUALATIN",
"state": "OR",
"postal_code": "970628856",
"telephone_number": "503-878-5412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6464 SW BORLAND RD STE C1",
"city": "TUALATIN",
"state": "OR",
"postal_code": "970628856",
"telephone_number": "503-878-5412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JASON",
"middle_name": "J",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-15",
"last_updated": "2018-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "163WA2000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Administrator",
"state": "OR",
"license": "2002409162RN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tualatin, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.