Jennifer Lynn Logan, M.D.

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

MD29229 Issued in OR

Practice address

3181 SW Sam Jackson Park Rd
Mail Code CB 669
Portland, OR 97239-3011

Phone

(503) 494-8311

Fax

(503) 494-4981

NPI assigned

Mar 22, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Miss Jennifer Lynn Underhill Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247529600000",
    "number": "1639295587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAIL CODE CB 669",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8311",
            "fax_number": "503-494-4981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAIL CODE CB 669",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8311",
            "fax_number": "503-494-4981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2009-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 97948",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "OR",
            "license": "MD29229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "UNDERHILL",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Steven Lofton
• Cindy Logan, CADC-R
• Deon F Logan, BA
• Ian Alexander Logan, M.D.
• Jenna C Logan
• Judith Rose Logan, MD
• Melissa Logan
• Naeemah Z Logan, MD
• Sally Gail Logan, RPH
• Seventh Xai Logas

• Public Health & General Preventive Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Public Health & General Preventive Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.