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General NPI Number Information
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NPI Number | 1992499065
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Entity Type | Individual
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Provider Name | MIKAYLA LOGUE
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Gender | Female
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Dates
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Enumeration Date | 06/02/2023
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 140 S ARTHUR ST STE 500
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City | SPOKANE
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State | WA
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Zip | 99202-2260
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Country | US
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Telephone | 509-744-1117
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Fax | 509-744-3055
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Provider Business Mailing Address
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Address Line | 140 S ARTHUR ST STE 500
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City | SPOKANE
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State | WA
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Zip | 99202-2260
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Country | US
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Telephone | 509-744-1117
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Fax | 509-954-3343
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LH61659992
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License Number State | WA
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