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Contact Information

DUSTIN M LOGAN, PHD
8201 N MICHAELSON ST
PALMER, AK99645-8196
 Phone: 907-745-5066
 Fax: 877-640-1413
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Neuropsychologist

103G00000X
 

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for DUSTIN M LOGAN · (Male)

NPI # 1851578512
Status Active
Credentials PHD
Entity Individual
Enumeration date 01/24/2008
Last updated 04/24/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • AK License # 121536
  • WA License # 60616291
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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