Individual
DR. LOGAN BUSHNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
615 LILLY RD NE STE 100, OLYMPIA, WA 98506-5117
(360) 491-4211
Mailing address
PO BOX 368, OLYMPIA, WA 98507-0368
(360) 491-8439
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
OP61480077
WA
207XX0801X
Orthopaedic Trauma Physician
OP61480077
WA
Other
Enumeration date
04/09/2018
Last updated
09/09/2024
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