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General NPI Number Information
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NPI Number | 1346451283
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Entity Type | Individual
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Provider Name | KIERSTEN A SMITH MOTRL
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Gender | Female
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | FORT VANCOUVER CONVALESCENT CENTER 8507 NE 8TH WAY
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City | VANCOUVER
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State | WA
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Zip | 98664
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Country | US
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Telephone | 360-254-5335
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Fax | 360-892-2086
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Provider Business Mailing Address
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Address Line | 21018 NE 212TH AVE
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City | BATTLE GROUND
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State | WA
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Zip | 98604-9617
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Country | US
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Telephone | 360-687-2333
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT00003454
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1056214
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License Number State | OR
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