Individual
EMMA LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1108 E 1ST ST, PORT ANGELES, WA 98362-4317
(360) 452-6216
(360) 452-8765
Mailing address
16083 SW UPPER BOONES FERRY RD STE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60599449
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0346769
WA L&I
WA
05
—
1548630759
—
WA
01
—
P01614787
RR MEDICARE
WA
Enumeration date
09/30/2015
Last updated
04/08/2016
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