DR. JACQUELINE SUSAN LOGAN (NPI# 1104905108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104905108 |
| Entity Type | Individual |
| Full Name | DR. JACQUELINE SUSAN LOGAN |
| Credential | MD |
| Practice Address |
2600 Center St Ne Oregon State Hospital Salem OR 97301 |
| Mailing Address |
Po Box 19055 Portland OR 97280-0055 |
| Practice Telephone | 5039452800 |
| Practice Fax Number | 5039452807 |
| Mailing Telephone | 5039986548 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD20914 | OR | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972165298 | Jacqueline Logan | Behavioral Analyst | 1902 Fairfax Ave, Cherry Hill, NJ 08003-2007 | 2019-07-08 |
| 1710257548 | Jacqueline Logan | Counselor | 108 E Ponce De Leon Ave Ste 204, Decatur, GA 30030-2512 | 2012-01-10 |
| 1487941852 | Jacqueline Rose Logan | Speech-Language Pathologist | 1500 Oxford Dr, Suite 10, Bethel Park, PA 15102-1823 | 2011-07-06 |
| Street Address |
2600 CENTER ST NE OREGON STATE HOSPITAL |
| City | SALEM |
| State | OR |
| Zip Code | 97301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407857295 | Charles J Rim | Dentist | 2600 Center St Ne, Salem, OR 97301-2669 | 2005-08-03 |
| 1467059782 | Lucas Arcoverde | Nurse Practitioner | 2600 Center St Ne, Salem, OR 97301-2669 | 2020-10-08 |
| 1548875834 | Mona Keivani | Pharmacist | 2600 Center St Ne, Salem, OR 97301-2682 | 2020-09-13 |
| 1689284739 | Nicole Humphrey | Psychologist | 2600 Center St Ne, Salem, OR 97301-2669 | 2020-08-04 |
| 1033733027 | Doris Okoli | Nurse Practitioner | 2600 Center St Ne, Salem, OR 97301-2682 | 2020-06-04 |
| 1679197370 | Kristopher Kurtis Adams | Psychologist | 2600 Center St Ne, Salem, OR 97301-2682 | 2020-05-29 |
| 1275162711 | Tyler St. Clair | Social Worker | 2600 Center St Ne, Salem, OR 97301-2682 | 2020-04-06 |
| 1689200784 | Sophia Jaeger-manson | Psychologist | 2600 Center St Ne, Salem, OR 97301-2669 | 2020-03-20 |
| 1154956548 | Connie Jo Mickelson | Dietitian, Registered | 2600 Center St Ne, Salem, OR 97301-2669 | 2020-03-06 |
| 1841824588 | Margherita Zaheera Vaulte | Psychologist | 2600 Center St Ne, Salem, OR 97301-2669 | 2020-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831708916 | P3 Health Partners-oregon LLC | Internal Medicine | 2525 12th St Se Ste 240250, Salem, OR 97302-2281 | 2020-07-24 |
| 1285279042 | Gaps Health Or PC | Internal Medicine | 780 Commercial St Se Ste 100, Salem, OR 97301-3465 | 2019-11-15 |
| 1427476753 | Lee Austin Fredrickson Jr. | Internal Medicine | 2020 E State St Ste C, Salem, OH 44460-2479 | 2014-04-03 |
| 1407119381 | Christina Joy Mckinnis | Internal Medicine | 27 Silverbrook Rd, Salem, NH 03079-4067 | 2012-06-16 |
| 1124331392 | Xi Zheng | Internal Medicine | 1049 Edgewater St Nw, Salem, OR 97304-4046 | 2010-07-16 |
| 1578894689 | Gary D Ollbrich Inc | Internal Medicine | 1044 Commercial St Se, Salem, OR 97302-4112 | 2010-01-29 |
| 1700114105 | Edward W Cipolla Do Pa | Internal Medicine | 330 Woodstown Rd Ste 1, Salem, NJ 08079-2093 | 2009-11-23 |
| 1053568592 | Garry Tim Miller II | Internal Medicine | 555 W Sr 164 North, Salem, UT 84653-1666 | 2008-08-27 |
| 1275700825 | Jatinder Aujla | Internal Medicine | 55 Highland Ave Ste 304, Salem, MA 01970-2100 | 2008-05-13 |
| 1780889386 | Ryan D Zaklin | Internal Medicine | 84 Highland Ave Ste 311, Salem, MA 01970-2733 | 2007-06-15 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.