Deidra A Logan, OT, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT61613593 Issued in WA

Practice address

4800 Sand Point Way NE
Seattle, WA 98105-3901

Phone

(818) 813-2216

NPI assigned

Apr 4, 2019

Last updated

Dec 10, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1477015725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 MCGILVRA BLVD E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981123123",
            "telephone_number": "818-813-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "818-813-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "DEIDRA",
        "middle_name": "A",
        "credential": "OT, OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-04",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT61613593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY",
            "identifier": "522754",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "OT61613593",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kasey Keegan Lofy, PA-C
• Matthew James Logalbo, MD
• Alexander Ascenzo Logan, M.D.
• Ashton Logan
• Connor Michael Logan, MD
• Karissa Logan, ND, EAMP
• Miles Gregory Logan
• Kendall Logar, B.C.B.A.
• James P Logerfo
• Sung Eun Logerfo, MD

• Occupational Therapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.