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General NPI Number Information
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NPI Number | 1306407648
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Entity Type | Individual
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Provider Name | AMY LYNN SMITH PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/26/2019
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 601 MCPHEE RD SW BLDG 1
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City | OLYMPIA
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State | WA
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Zip | 98502-5080
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Country | US
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Telephone | 360-596-4614
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Fax | 360-596-4615
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Provider Business Mailing Address
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Address Line | PO BOX 5299 MS: 820-5-PCO
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City | TACOMA
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State | WA
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Zip | 98415-0299
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Country | US
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Telephone | 253-459-8231
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA61466176
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License Number State | WA
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