Individual
LOGAN ANDREW VILLARREAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
624 E FRONT AVE, SPOKANE, WA 99202-2139
(509) 626-9900
(509) 626-9917
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
(509) 227-7070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD61113757
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2018
Last updated
04/28/2021
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