NPI 1073226452

Tyler Kenneth Johnson, DO

Practitioner Military Health Care Provider Lebanon, OR

Practice location

Address: 200 Mullins Dr, Lebanon, OR 97355-3983
Phone: (541) 259-0235
Mailing address: 101 Bodin Cir, Fairfield, CA 94535-1809

Registered specialties (2)

Military Health Care Provider Primary

Other Service Providers Taxonomy 171000000X

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1073226452
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Jan 2023
Record last updated: 18 Jun 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.