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Individual

LOGAN LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
275 SW 160TH ST STE 105, BURIEN, WA 98166-3073
(206) 513-2155
(206) 513-2886
Mailing address
275 SW 160TH ST STE 105, BURIEN, WA 98166-3073
(206) 513-2155
(206) 513-2886

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT70029666
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
535600
NBCOT
WA
Enumeration date
11/02/2020
Last updated
11/05/2025
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