Healthcare Provider Details

I. General information

NPI: 1316072911
Provider Name (Legal Business Name): NICHOLAS WILLIAM SMURRO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9873 BRIDGEPORT WAY SW
LAKEWOOD WA
98499-2895
US

IV. Provider business mailing address

1525 S WILTON RD
TACOMA WA
98465-1032
US

V. Phone/Fax

Practice location:
  • Phone: 253-588-1707
  • Fax: 253-984-6731
Mailing address:
  • Phone: 253-565-6017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1992
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number1992
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: