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MS. MALLORY JOHNSON PEDIATRIC NP
NPI 1265699508
Nurse Practitioner - Pediatrics in Portland, OR

Active since May 22, 2008
11790 SW BARNES RD. BLG A, STE 140, PORTLAND, OR 97225(503) 643-2100(503) 643-7300 Get Directions Write a Review

NPPES record last updated: October 18, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Mallory Johnson Pediatric Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. MALLORY JOHNSON PEDIATRIC NP (NPI 1265699508) is an individual pediatrics provider in Portland, Oregon, licensed in Oregon (200850163NP) and active in the NPI registry since May 2008.

NPPES Registry Identity

NPI1265699508
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameMS. MALLORY JOHNSONCredential: PEDIATRIC NP
Location Address11790 SW BARNES RD. BLG A, STE 140Portland, OR 97225
Mailing Address11790 Sw Barnes Rd. Blg A, Ste 140Portland, OR 97225 · (503) 643-2100 · Fax (503) 643-7300
Phone(503) 643-2100
Fax(503) 643-7300
Sole ProprietorYes
Enumeration DateMay 22, 2008
Last NPPES UpdateOctober 18, 2021
NPPES CertifiedOctober 18, 2021
✔ NPI 1265699508 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in OR · 200850163NP
11790 SW BARNES RD. BLG A, Portland, OR 97225
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Other Names 1

Former Name (1)Mallory Braun Pediatric Nurse Prac

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mallory Johnson's NPI number?

The NPI number for Mallory Johnson is 1265699508. It was assigned to this individual provider in the NPPES registry on May 22, 2008. The provider is also known as Mallory Braun Pediatric Nurse Prac.

Where is Mallory Johnson located?

Mallory Johnson practices at 11790 SW Barnes Rd. Blg A Ste 140, Portland, OR 97225. The listed phone number is (503) 643-2100.

What is Mallory Johnson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

What insurance does Mallory Johnson accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and Regence BlueCross BlueShield of Oregon list Mallory Johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mallory Johnson was last updated on October 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.