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General NPI Number Information
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NPI Number | 1043362882
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Entity Type | Individual
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Provider Name | GERALD W SMITH O.D.
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Gender | Male
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 15446 BEL RED RD
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City | REDMOND
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State | WA
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Zip | 98052-5501
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Country | US
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Telephone | 425-883-5320
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 34584
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City | SEATTLE
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State | WA
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Zip | 98124-1584
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Country | US
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Telephone | 509-241-7349
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Fax | 509-241-7628
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OD00000787
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | MS1246897
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License Number State | WA
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