Jeanne Pauly Johnson, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

109663 Issued in CA

Practice address

2386 NW Hoyt St
Portland, OR 97210-3219

Phone

(503) 228-5909

Fax

(503) 226-4186

NPI assigned

Oct 23, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Jeanne Pauly Johnson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1256256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1679809776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2386 NW HOYT STREET",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97210",
            "telephone_number": "503-228-5909",
            "fax_number": "503-226-4186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2386 NW HOYT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103219",
            "telephone_number": "503-228-5909",
            "fax_number": "503-226-4186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEANNE",
        "middle_name": "PAULY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-23",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "109663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNE",
            "last_name": "JOHNSON",
            "middle_name": "PAULY",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• James C Johnson, MD
• Janee Johnson, M.S. CAP
• Janice Lynne Johnson
• Jason Alan Johnson, PSY.D.
• Jason Lee Johnson, MASSAGE THERAPIST
• Jeff Johnson
• Jeffrey P Johnson, M.D.
• Jenna Alane Johnson, LPC, CADC-I
• Jennifer Christine Johnson, PHD
• Jennifer Leigh Johnson, N.D., L.AC.

• Psychiatry Physician in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.