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1104905108
JACQUELINE SUSAN LOGAN
SALEM, OR
NPI
1104905108
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: OR MD20914)
Enumeration Date
2006-11-02
Last Update Date
2007-07-08
Business Address
Dr. JACQUELINE SUSAN LOGAN MD
2600 CENTER ST NE OREGON STATE HOSPITAL
SALEM, OR 97301
Phone number: 503-945-2800
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Mailing Address
Dr. JACQUELINE SUSAN LOGAN MD
PO BOX 19055
PORTLAND, OR 97280-0055
Phone number: 503-998-6548
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