SALLY LOGAN (NPI# 1891052023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891052023 |
| Entity Type | Individual |
| Full Name | SALLY LOGAN |
| Credential | QMHA |
| Practice Address |
621 W Madrone St Roseburg OR 97470-3090 |
| Practice Telephone | 5416710619 |
| Mailing Telephone | 5416710619 |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2013-02-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356828768 | Sally Gail Logan | Pharmacist | 5725 Ne 138th Avenue, Portland, OR 97230 | 2018-07-27 |
| 1023298650 | Sally Stephens Logan | Dietitian, Registered | 1732 Buckley Arch, Virginia Beach, VA 23453-7081 | 2007-11-12 |
| Street Address |
621 W MADRONE ST |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97470-3090 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174571244 | Linda Lou Westfall | Nurse Practitioner | 621 W Madrone St, Suite 223, Roseburg, OR 97470-3090 | 2006-05-04 |
| 1093322919 | Natasha Ritson | Peer Specialist | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-09-24 |
| 1427664630 | Sara Clark | Peer Specialist | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-09-22 |
| 1538775754 | Aurora Petterson | Case Manager/Care Coordinator | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-09-22 |
| 1730794884 | Paige Nicole Hosford | Counselor | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-09-14 |
| 1922612035 | Fatima Jalloh | Counselor | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-09-04 |
| 1013528272 | Mae L Hoopes | Counselor | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-08-12 |
| 1265040018 | Angelica Laurent | Case Manager/Care Coordinator | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-07-17 |
| 1417574898 | Bryn Orr | Case Manager/Care Coordinator | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-07-01 |
| 1508481912 | Jeremy Michael Smith | Counselor | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-06-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326547134 | Thoughtwork, LLC | Social Worker | 178 Nw Garden Valley Blvd, Roseburg, OR 97470 | 2018-02-07 |
| 1063932960 | Go Mo, LLC | Durable Medical Equipment & Medical Supplies | 627 Se Jackson St, Roseburg, OR 97470 | 2017-06-21 |
| 1497123335 | Brandi N Hamilton | Counselor | 215 S.e. Jackson, Roseburg, OR 97470 | 2015-09-09 |
| 1285031203 | Aric Fromdahl | Counselor | 215 Se Jackson, Roseburg, OR 97470 | 2014-11-20 |
| 1801292438 | Robin Knebel | Counselor | 215 Se Jackson St., Roseburg, OR 97470 | 2014-11-10 |
| 1700282415 | Samantha Marie Shelley | Counselor | 215 Se Jackson Street, Roseburg, OR 97470 | 2014-11-06 |
| 1043610660 | Cynthia Simmons | Counselor | 150 Ne Kenneth Ford Drive, Roseburg, OR 97470 | 2014-09-02 |
| 1083025431 | Toni Damewood Msn Pmhnp-bc | Nurse Practitioner | 770 Se Kane Street, Roseburg, OR 97470 | 2014-05-19 |
| 1801226196 | Denise Ingeman | Registered Nurse | 1548 South East Pine Street, Roseburg, OR 97470 | 2013-11-22 |
| 1356606909 | Carla Junette Rambel | Massage Therapist | 566 S.e. Jackson, Roseburg, OR 97470 | 2012-07-10 |
| Find all providers in zip 97470 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770034589 | Evie Jepsen | Case Manager/Care Coordinator | 2700 Stewart Parkway Annex B, Suite 110, Roseburg, OR 97471 | 2016-10-17 |
| 1932580586 | Jeffrey Mark Wareham | Case Manager/Care Coordinator | 2700 Medical Loop, Annex B, Roseburg, OR 97471 | 2015-06-09 |
| 1215040175 | Patricia Ann Taylor | Case Manager/Care Coordinator | 337 Se Fowler St, Roseburg, OR 97470-4348 | 2006-08-16 |
| 1194322396 | Christopher Hudgeon | Case Manager/Care Coordinator | 548 Se Jackson St, Roseburg, OR 97470-4983 | 2020-10-01 |
| 1538775754 | Aurora Petterson | Case Manager/Care Coordinator | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-09-22 |
| 1265040018 | Angelica Laurent | Case Manager/Care Coordinator | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-07-17 |
| 1770101719 | Travis Mcdowell | Case Manager/Care Coordinator | 283 Se Fowler St Ste 2, Roseburg, OR 97470-3309 | 2020-07-07 |
| 1417574898 | Bryn Orr | Case Manager/Care Coordinator | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-07-01 |
| 1689298754 | Cindy Walls | Case Manager/Care Coordinator | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-06-03 |
| 1144849589 | Larry Dale Clark | Case Manager/Care Coordinator | 621 W Madrone St, Roseburg, OR 97470-3090 | 2020-04-15 |
| Find all providers in ROSEBURG | ||||
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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.