Individual
LOGAN DONOVON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
101 E MAIN ST STE 209, MONROE, WA 98272-1519
(360) 485-0820
(949) 404-8981
Mailing address
19916 OLD OWEN RD # 152, MONROE, WA 98272-9778
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/07/2021
Last updated
06/27/2021
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