Individual
DEIDRA A LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT, OTD, OTR/L
Contact information
Practice address
4800 SAND POINT WAY NE, SEATTLE, WA 98105-3901
(818) 813-2216
Mailing address
1855 MCGILVRA BLVD E, SEATTLE, WA 98112-3123
(818) 813-2216
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT61613593
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
522754
NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
—
01
—
OT61613593
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
04/04/2019
Last updated
12/10/2024
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