SearchIdaho222Q00000X

Logan Pluckebaum, IP

NPI 1649158718 · on the registry since 2025 · sole proprietor

Practice

Address
7557 W Ustick Rd
Boise, ID 83704
Phone
(208) 890-4405

Registry record

Primary taxonomy
222Q00000X
222Q00000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2025-08-26

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho