Lee Michael Johnson, OD | |
800 Main Ave Ste A, Tillamook, OR 97141-3760 | |
(503) 842-5568 | |
Not Available |
Full Name | Lee Michael Johnson |
---|---|
Gender | Male |
Speciality | Optometry |
Experience | 13 Years |
Location | 800 Main Ave Ste A, Tillamook, Oregon |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1104113497 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 2698 (Georgia) | Secondary |
152W00000X | Optometrist | AT-4289 (Oregon) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Adventist Health Tillamook | Tillamook, OR | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Tvc Od, Llc | 1456619360 | 2 |
Provider Name | Tvc Od, Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1790215192 PECOS PAC ID: 1456619360 Enrollment ID: O20171226001850 |
Mailing Address | Practice Location Address |
---|---|
Lee Michael Johnson, OD 800 Main Ave Ste A, Tillamook, OR 97141-3760 Ph: (503) 842-5568 | Lee Michael Johnson, OD 800 Main Ave Ste A, Tillamook, OR 97141-3760 Ph: (503) 842-5568 |
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