Individual
DR. JACQUELINE SUSAN LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2600 CENTER ST NE, OREGON STATE HOSPITAL, SALEM, OR 97301
(503) 945-2800
(503) 945-2807
Mailing address
PO BOX 19055, PORTLAND, OR 97280-0055
(503) 998-6548
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD20914
OR
Other
Enumeration date
11/02/2006
Last updated
07/08/2007
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