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General NPI Number Information
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NPI Number | 1205805975
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Entity Type | Individual
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Provider Name | GARY L SMITH DC
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Gender | Male
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 07/08/2020
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Provider Practice Location Address
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Address Line | 337 NE 5TH AVE
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City | CAMAS
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State | WA
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Zip | 98607-2033
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Country | US
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Telephone | 360-834-7533
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Fax | 360-834-3084
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Provider Business Mailing Address
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Address Line | 337 NE 5TH AVE
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City | CAMAS
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State | WA
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Zip | 98607-2030
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Country | US
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Telephone | 360-834-7533
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Fax | 360-834-3084
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 27 2622
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH00003521
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License Number State | WA
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