Provider Demographics
NPI:1548594807
Name:RAMSEY, LOGAN WAYNE (LMP)
Entity Type:Individual
Prefix:
First Name:LOGAN
Middle Name:WAYNE
Last Name:RAMSEY
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 OAK ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WA
Mailing Address - Zip Code:98354-9234
Mailing Address - Country:US
Mailing Address - Phone:253-778-0776
Mailing Address - Fax:
Practice Address - Street 1:1107 OAK ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:WA
Practice Address - Zip Code:98354-9234
Practice Address - Country:US
Practice Address - Phone:253-778-0776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-18
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60091119225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist