Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Logan Ellis

Individual provider Athletic Trainer · NPI 1568900769

Logan Ellis is an Athletic Trainer in Boise, Idaho. Practices as a sole proprietor and works from 3 locations. Licensed in Idaho.

Licensed in
ID
In the registry since
2017
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Practice location Address checks out

703 S Americana Blvd Ste 120
Boise, ID 83702-6754
Phone: (208) 489-5543
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 520 W Spruce St Apt A203, Missoula, MT 59802-4041 — (503) 880-4532
  • 520 W Spruce St Apt A203, Missoula, MT 59802-4041 — (503) 880-4532

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AT-641 (ID)

Record details

NPI number1568900769
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 8, 2017
Last updated in NPPESMarch 17, 2018
Mailing address9630 W Leo Ct, Boise, ID 83709-8250

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