Individual
LOGAN S PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(509) 684-4597
(509) 690-5785
Mailing address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(509) 684-4597
(509) 690-5785
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG70048486
WA
175T00000X
Peer Specialist
Primary
CG70048486
WA
Other
Enumeration date
09/12/2025
Last updated
11/06/2025
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