Provider Demographics
NPI:1568930121
Name:MUZZEY, LOGAN ALEXANDER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LOGAN
Middle Name:ALEXANDER
Last Name:MUZZEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 S 362ND PL
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-7154
Mailing Address - Country:US
Mailing Address - Phone:314-620-7640
Mailing Address - Fax:
Practice Address - Street 1:2925 HARRISON AVE NW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-2566
Practice Address - Country:US
Practice Address - Phone:360-570-4617
Practice Address - Fax:360-570-4627
Is Sole Proprietor?:No
Enumeration Date:2018-11-12
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018028745183500000X
WAPH60918750183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist