Individual
LOGAN MIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
605 S COOLIDGE ST, MOSES LAKE, WA 98837-1873
(509) 765-0674
Mailing address
605 S COOLIDGE ST, MOSES LAKE, WA 98837-1873
(509) 765-0674
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
DR.0062186
CO
207Q00000X
Family Medicine Physician
Primary
MD61113448
WA
Other
Enumeration date
04/04/2016
Last updated
06/16/2021
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