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Logan Michael Johnston
Medical Physician Assistant in Tigard, Oregon
NPI 1144834805

Logan Michael Johnston is a Medical Physician Assistant based in Tigard, OR and is specialized in Medical. Logan Michael Johnston practices in Tigard, OR. The NPI Number for Logan Michael Johnston is 1144834805 and holds a License No. (Oregon).

The current practice location address for Logan Michael Johnston is 9735 Sw Shady Ln Ste 102, Tigard, OR and can be reached out via phone at 503-620-5614.

Location: 9735 Sw Shady Ln Ste 102, Tigard, OR, 97223-5481
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1144834805
Provider Name
Logan Michael Johnston
Credential
Provider Entity Type
Individual
Gender
Male
Address
9735 Sw Shady Ln Ste 102, Tigard, OR, 97223-5481
Phone Number
503-620-5614
Fax Number
Provider Enumeration Date
09/01/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
9735 Sw Shady Ln Ste 102
City
Tigard
State
Oregon
Zip
97223-5481
Phone Number
503-620-5614
Fax Number
person
Provider Business Mailing Address Details
Address
9735 Sw Shady Ln Ste 102
City
Tigard
State
Oregon
Zip
97223-5481
Phone Number
503-620-5614
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
()
Definition
Definition to come...
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