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NPI Code Detail

MEDICARE: HEATHER K SMITH L.M.P.

MEDICARE: HEATHER K SMITH L.M.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMA00023603WA

General Provider Information

NPI Number : 1548443575
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER K SMITH L.M.P.
Provider Business Mailing Address
First Line : 1420 NW GILMAN BLVD
Second Line : SUITE 2-252
City : ISSAQUAH
State : WA
Zip : 98027-5394
Country : US
Telephone Number : 425-241-8393
Fax Number :
Provider Business Practice Location Address
First Line : 1420 NW GILMAN BLVD
Second Line : SUITE 2-252
City : ISSAQUAH
State : WA
Zip : 98027-5394
Country : US
Telephone Number : 425-241-8393
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2007
Last Update Date : 07/31/2014

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