Provider Demographics
NPI:1083710073
Name:HORNE, LANDON T (M D)
Entity type:Individual
Prefix:
First Name:LANDON
Middle Name:T
Last Name:HORNE
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 NE 20TH AVE STE 232
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2862
Mailing Address - Country:US
Mailing Address - Phone:503-963-2801
Mailing Address - Fax:503-963-2825
Practice Address - Street 1:5050 NE HOYT ST STE 340
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2983
Practice Address - Country:US
Practice Address - Phone:503-234-9861
Practice Address - Fax:503-238-0873
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD25533207X00000X, 207XS0106X
WAMD00040852207X00000X, 207XS0106X
ORMD225472207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8413395Medicaid
WA8413395Medicaid
WA8870586Medicare PIN