Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lyndon G Johansen, DPM

Individual provider Podiatrist · NPI 1306820402

Lyndon G Johansen, DPM is a Podiatry in Portland, Oregon. Graduated from California School of Podiatric Medicine in 1990, 36 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
36
Trained at
California School of Podiatric Medicine
Licensed in
OR
In the registry since
2005
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

12658 SE Stark St
Portland, OR 97233-1058
Phone: (503) 256-4018
Fax: (503) 256-6298
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X · Licence DP00230 (OR)

Record details

NPI number1306820402
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorYes
NPI enumeratedDecember 1, 2005
Last updated in NPPESJanuary 2, 2013
Mailing address12658 Se Stark St, Portland, OR 97233-1058

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolCALIFORNIA SCHOOL OF PODIATRIC MEDICINE
Graduated 1990 (36 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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