| Doctor Name: | MR. JAMES LOGAN PHILLIPPE |
| NPI Number: | 1073794194 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN |
| License Number: | |
| Business Practice Address: | 8495 Crater Lake Hwy White City, OR - 97503 |
| Business Phone Number: | 5418262111 |
| Business Fax Number: | |
| Mailing Address: | 8495 Crater Lake Hwy, WHITE CITY |
| State: | OR |
| Postal Code: | 975033011 |
| Phone Number: | 5418262111 |
| Fax Number: | |
| NPI Enumeration Date: | 11/16/2007 |
| NPI Last Update Date: | 11/16/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |