Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1255680831 Individual Practitioner Male Practitioner

Dr. Mark Ronald Johansen , DC

Chiropractor • Portland, OR

Professional Overview & Biography Verified Profile Summary

Dr. Mark Johansen, DC is a registered healthcare professional specializing in Chiropractor in Portland, OR. Practice services are available at 12762 SE STARK ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

12762 Se Stark St
Plaza 125 Bldg. D

Portland, OR 972331539

Telephone 5032557746
Associated Practice Facility / Clinic
🏢 Chiropractic Life Center Pc Facility NPI 1235302795

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Portland, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 17.1 Yrs
State Avg: 22.2 Yrs
Regional Practice Density
594 Specialists

Practicing in Portland, OR (1950 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License OR 5072

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1043301088

Doctor of Chiropractic

Dr. Ronald Johansen , DC

Chiropractor - Orthopedic

NPI 1043302409

Doctor of Chiropractic

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active September 04, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location September 04, 2012

Registered at 12762 SE STARK ST, PLAZA 125 BLDG. D, PORTLAND, OR 972331539 (Tel: 5032557746)

📍
Updated Business Mailing Address September 04, 2012

Registered at 14661 SE 172ND AVE, CLACKAMAS, OR 970157771 (Tel: 5039985314)

👤
Provider Name / Credentials Updated September 04, 2012

Recorded as MARK JOHANSEN, D.C.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 04, 2012

Chiropractor (License #5072 in OR)

🟢
Initial NPI Registration & Enumeration August 29, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1255680831
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 29, 2012
Last Update: September 04, 2012
Sole Proprietor: Yes

Mailing Address

14661 Se 172nd Ave

Clackamas, OR 970157771

Phone: 5039985314

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.