Healthcare Provider Details
I. General information
NPI: 1477523637
Provider Name (Legal Business Name): ELIZABETH TRICE LOGGERS M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/23/2006
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3485 S BOND AVE
PORTLAND OR
97239-4503
US
IV. Provider business mailing address
3181 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3098
US
V. Phone/Fax
- Phone: 503-494-5058
- Fax:
- Phone: 503-494-5058
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | 60111734 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | 230684 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: