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Individual

KERIE LOGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCHT

Contact information

Practice address
958 CLOVERLEAF LN NE, KEIZER, OR 97303-4606
(503) 584-1227
Mailing address
PO BOX 21081, KEIZER, OR 97307-1081
(503) 584-1227

Taxonomy

Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
H17969
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
197625594
BUSINESS REGISTRY
OR
Enumeration date
05/31/2022
Last updated
05/31/2022
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