KELLY LOGGAN (NPI# 1851753081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1851753081 |
Entity Type | Individual |
Full Name | KELLY LOGGAN |
Credential | L.M.T. |
Practice Address |
2080 Se Oak Grove Blvd Suite 7 Portland OR 97267-2657 |
Practice Telephone | 5037869940 |
Practice Fax Number | 5037869940 |
Mailing Telephone | 5037869940 |
Mailing Fax Number | 5037869940 |
Enumeration Date | 2016-03-26 |
Last Update Date | 2016-03-26 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 246Z00000X | Specialist/Technologist, Other | 3609 | OR | Technologists, Technicians & Other Technical Service Providers |
Street Address |
2080 SE OAK GROVE BLVD SUITE 7 |
City | PORTLAND |
State | OR |
Zip Code | 97267-2657 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851911036 | Michelle Renee Gilham | Massage Therapist | 16560 S.e. 80th Ave, Portland Or 97267, 19650 Se 80th Ave, Portland, OR 97267 | 2020-04-17 |
1629557442 | Benchmark Physical Therapy of Or, LLC | Occupational Therapist | 14874 Se Webster Rd, Milwaukie, OR 97267 | 2018-08-13 |
1326541764 | Theresa Elaine Day | Massage Therapist | 2080 Se Oak Grove Blvd Ste 16, Portland, OR 97267 | 2018-03-12 |
1881015378 | Kathryn Louise Engstrom | Registered Nurse | 6901 Se Lake Road, Portland, OR 97267 | 2013-12-30 |
1285951293 | Eliza Ann Rowley | Acupuncturist | 2080 Se Oak Grove Blvd #9, Milwaukie, OR 97267 | 2010-04-29 |
1346438124 | Rx Direct Inc | Pharmacy | 16246 Se Mcloughlin, Milwaukie, OR 97267 | 2007-10-05 |
1477740827 | Olson Drug, Inc | Durable Medical Equipment & Medical Supplies | 16244 Se Mcloughlin Blvd, Milwaukie, OR 97267 | 2007-10-01 |
1831308451 | Jeannie Marie Baer | Massage Therapist | 16705 Se Mcloughlin, Milwaukie, OR 97267 | 2007-05-21 |
1902923667 | Matthew William Krueger | Specialist/Technologist | 4950 Se Roethe Rd., Milwaukie, OR 97267 | 2007-03-26 |
1316084049 | Renee' Lorena Raschke | Counselor | 17070se Mcloughlin Blvd., Milwaukie, OR 97267 | 2007-01-31 |
Find all providers in zip 97267 |
Taxonomy Code | 246Z00000X |
Grouping | Technologists, Technicians & Other Technical Service Providers |
Classification | Specialist/Technologist, Other |
General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487143129 | Angelina Lucretia Anderson | Specialist/Technologist, Other | 191 Ne Grand Ave, Portland, OR 97232-2936 | 2018-05-08 |
1760856231 | Clifton A. J. Edwards | Specialist/Technologist, Other | 3347 Ne 164th Loop, Portland, OR 97230-5063 | 2015-11-21 |
1841808896 | Katirina Guanciale | Specialist/Technologist, Other | 9115 Sw Oleson Rd, Portland, OR 97223-6875 | 2020-07-15 |
1225459589 | Victoria Faith Turek | Specialist/Technologist, Other | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2014-01-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306496732 | Grady Paul Bunce | Specialist/Technologist, Other | 2525 Cal Young Rd Fl 3, Eugene, OR 97401-6477 | 2019-09-17 |
1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
1639525140 | Molly Ballew | Specialist/Technologist, Other | 295 E Main, Suite 10, Ashland, OR 97520-0020 | 2016-05-13 |
1114373735 | Ayako Shimba | Specialist/Technologist, Other | 2935 Se 73rd Ave, Hillsboro, OR 97123-6223 | 2016-05-12 |
1285091009 | Bryon Willson | Specialist/Technologist, Other | 3350 Sw 198th Ave, Beaverton, OR 97003-2348 | 2016-01-25 |
1497183362 | Faith Tavares Pinkerton | Specialist/Technologist, Other | 61383 Hwy 97, Suite B, Bend, OR 97702-2597 | 2013-10-31 |
1508105735 | Mary Elizabeth Smith | Specialist/Technologist, Other | 11855sw Ridgecrest Dr, #209, Beaverton, OR 97008 | 2013-02-07 |
1285861609 | Maruska Lynch | Specialist/Technologist, Other | 12395 Se Oatfield Rd, Milwaukie, OR 97222-6954 | 2009-06-11 |
1942454400 | Valerie Jane Hefner | Specialist/Technologist, Other | 1949 Ne Lotus Dr, Bend, OR 97701-6127 | 2008-11-11 |
1043461189 | Michael A Isleman | Specialist/Technologist, Other | 7137 Sw Sagert St, Tualatin, OR 97062-8297 | 2008-10-07 |
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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.