Individual
LOGAN MICHAEL JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
511 SW 10TH AVE STE 1301, PORTLAND, OR 97205-2780
(503) 228-0155
(503) 226-8342
Mailing address
511 SW 10TH AVE STE 1301, PORTLAND, OR 97205-2780
(503) 228-0155
(503) 226-8342
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
09/01/2020
Last updated
08/26/2024
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