Provider Demographics
NPI:1275661423
Name:LOGSDON, VALERIE KAY (MD)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:KAY
Last Name:LOGSDON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 E HIGH DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-2813
Mailing Address - Country:US
Mailing Address - Phone:509-443-7288
Mailing Address - Fax:
Practice Address - Street 1:315 W 9TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2501
Practice Address - Country:US
Practice Address - Phone:509-624-3126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00045218261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty