Healthcare Provider Details

I. General information

NPI: 1225141187
Provider Name (Legal Business Name): KAREN LOUISE SMITH LPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PUGET SOUND HALTH CARE SYSTEM; SEATTLE DIVISION RCS-117 1660 S COLUMBIAN WAY
SEATTLE WA
98108
US

IV. Provider business mailing address

PO BOX 33372
PORTLAND OR
97292-3372
US

V. Phone/Fax

Practice location:
  • Phone: 206-277-3462
  • Fax: 206-764-2263
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number7486
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: