Individual
KATLYNN FEAGANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
305 PACIFIC AVE S STE 102, KELSO, WA 98626-1638
(360) 423-0203
(360) 423-5086
Mailing address
PO BOX 1847, LONGVIEW, WA 98632-8140
(360) 423-0203
(360) 577-0269
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CG60840892
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2101685
—
WA
Enumeration date
04/14/2018
Last updated
03/28/2022
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