LOGAN SHANE – Professional Counselor, NPI 1942770706

LOGAN SHANE is a healthcare provider. based in Burien, Washington. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. C6266 (OR). The NPI Number for LOGAN SHANE is 1942770706

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
LOGAN SHANE
NPI
1942770706
Phone
Not provided
Address
1210 SW 136TH ST
Enumeration Date
4 December 2018
Last Update Date
11 August 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5413227400
Graduation Year
2018 (8 years ago)
PAC ID
4981054061
Group Practice PAC ID
9638083371
Professional Enrollment ID
I20240102002992
Address ID
OR977017638BE2577XDRXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:7State licenses:1Digital endpointsOther names

1,452 MENTAL HEALTH COUNSELOR in WA

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Provider Addresses for LOGAN SHANE

  • King County Public Health - Primary Care, 1210, Southwest 136th Street, Alturas @ Burien, Burien, King County, Washington, 98146-3169, United States

    BURIEN, WA 981661214

    Phone:

    Type: Mailing

  • 2577 NE COURTNEY DR

    BEND, OR 977017752

    Phone: (541) 322-7500

    Fax: (541) 322-7565

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240102002992IMental Health CounselorORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98166)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638083371View full group profile
NameSpecialtyState
Nurse PractitionerOR
P S Y C H I A T R YOR
Mental Health CounselorOR
Clinical Social WorkerOR
-OR
Infectious DiseaseOR
Occupational Therapist In Private PracticeOR
Clinical Social WorkerOR
Mental Health CounselorOR
Mental Health CounselorOR

Reviews

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Frequently asked questions

Can I verify LOGAN SHANE with an NPI only?
You can start verification with NPI 1942770706 for LOGAN SHANE, then check state licensing separately.
Is LOGAN SHANE listed as active for patients and plans?
The listing shows LOGAN SHANE as active in the NPI system.
What is LOGAN SHANE's specialty?
The listing groups LOGAN SHANE with Professional Counselor. Clinical services aligned with this taxonomy classification.
Where should I expect LOGAN SHANE on a map?
Expect Burien, Washington as a primary anchor for LOGAN SHANE unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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