Keith, Jack Logan

Keith, Jack Logan is an individual health care provider with primary practice located at 3857 Martin Way E , Olympia WA 98506. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Behavioral Health & Social Service Providers / Mental Health, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Keith, Jack Logan can be contacted via phone (253) 581-7020.

Contact Information

Primary practice address
3857 Martin Way E Olympia WA 98506
Phone: (253) 581-7020
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AP61193548 Washington
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Nursing Service Providers / Registered Nurse 163W00000X N60493722 Washington
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 202110580NP-PP Oregon

Profile Details

NPI number 1982968210
LBN Legal business name Keith, Jack Logan
Credentials PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2012
Last updated Dec 7th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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