Logan Stephen Bannon

NPI #1003494618 in Seattle, Washington

Provider Information

NPI Number: 1003494618
Entity Type: Individual
Name: Logan Stephen Bannon
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Apr 2, 2021
Last Updated: Apr 2, 2021

Practice Location

Address: 1107 NE 45TH ST STE 100
City: Seattle
State: Washington
ZIP Code: 98105-4631
Phone: (206) 545-7844

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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