Healthcare Provider Details

I. General information

NPI: 1083110613
Provider Name (Legal Business Name): CIERRA CHANTEL SMITH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CIERRA CHANTEL LOHAUS

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W 8TH AVE STE 7050
SPOKANE WA
99204-2362
US

IV. Provider business mailing address

PO BOX 31001-4114
PASADENA CA
91110-4114
US

V. Phone/Fax

Practice location:
  • Phone: 509-252-1711
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License NumberDO.OP.70107869
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License NumberOT022080
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34.015115
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: