Healthcare Provider Details

I. General information

NPI: 1902723083
Provider Name (Legal Business Name): SKIFT METABOLIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 W RIVERSIDE AVE # 7845
SPOKANE WA
99201-0580
US

IV. Provider business mailing address

522 W RIVERSIDE AVE # 7845
SPOKANE WA
99201-0580
US

V. Phone/Fax

Practice location:
  • Phone: 509-210-2722
  • Fax:
Mailing address:
  • Phone: 509-210-2722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM CLARK SMITH
Title or Position: OWNER
Credential: PA-C
Phone: 925-826-2098