Individual
JUDITH ROSE LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, MAILCODE: BICC, PORTLAND, OR 97239-3011
(503) 494-5902
Mailing address
3181 SW SAM JACKSON PARK RD, MAILCODE: BICC, PORTLAND, OR 97239-3011
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD15413
OR
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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