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Individual

JENNIFER DAWN LOGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN, FNP-BC

Contact information

Practice address
11802 NE 65TH ST STE 100, VANCOUVER, WA 98662-5521
(360) 253-6883
Mailing address
PO BOX 820852, VANCOUVER, WA 98682-0019

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9252175
FL
363L00000X
Nurse Practitioner
ARNP9252175
FL
363LF0000X
Family Nurse Practitioner
201810264NP-PP
OR
363LF0000X
Family Nurse Practitioner
312019
AZ
363LF0000X
Family Nurse Practitioner
344080
NY
363LF0000X
Family Nurse Practitioner
Primary
AP61131815
WA
363LF0000X
Family Nurse Practitioner
APRN101674
WV
363LF0000X
Family Nurse Practitioner
C-APN.0101436-C-NP
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1598039984
NPI NUMBER
Enumeration date
03/02/2012
Last updated
12/08/2024
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