Healthcare Provider Details

I. General information

NPI: 1528868189
Provider Name (Legal Business Name): ZOE JADE SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 1ST PL NW STE A
ISSAQUAH WA
98027-2746
US

IV. Provider business mailing address

4715 42ND AVE SW APT E-623
SEATTLE WA
98116-4634
US

V. Phone/Fax

Practice location:
  • Phone: 425-623-9414
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: