Logan Donovon Smith, BS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

101 E Main St Ste 209
Monroe, WA 98272-1519

Phone

(360) 485-0820

Fax

(949) 404-8981

NPI assigned

May 7, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• A Different Path Counseling, PLLC

  • Community/Behavioral Health Agency
  • Monroe, WA
  • NPI 1093358731
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624752000000",
    "number": "1235713009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19916 OLD OWEN RD # 152",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982729778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MAIN ST STE 209",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721519",
            "telephone_number": "360-485-0820",
            "fax_number": "949-404-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LOGAN",
        "middle_name": "DONOVON",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-06-27",
        "certification_date": "2021-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sky Valley Wellness, LLC
• Dawn Elizabeth Slack, LMT
• Chrystal Slatter, CERTIFIED PEER COUNS
• Gary O Smith, RPH
• Kristin Tomblin Smith, LMP
• Michelle Christina Smith
• Snohomish County Fire District 3
• Snohomish Regional Fire and Rescue
• Snohomish Valley Breastfeeding
• Jennifer Solley, PHARMD

• Student in an Organized Health Care Education/Training Program in Monroe, WA
• Providers in Monroe, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.