Individual
KELLY LOGGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
2080 SE OAK GROVE BLVD, SUITE 7, PORTLAND, OR 97267-2657
(503) 786-9940
(503) 786-9940
Mailing address
2080 SE OAK GROVE BLVD, SUITE 7, PORTLAND, OR 97267-2657
(503) 786-9940
(503) 786-9940
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
3609
OR
Other
Enumeration date
03/26/2016
Last updated
03/26/2016
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