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Individual

MICHAEL J LOGUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10513 SILVERDALE WAY NW, STE 101, SILVERDALE, WA 98383
(360) 692-1848
(360) 692-1912
Mailing address
10513 SILVERDALE WAY NW, STE 101, SILVERDALE, WA 98383
(360) 692-1848
(360) 692-1912

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00037654
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8262529
WA
Enumeration date
10/02/2006
Last updated
05/30/2008
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