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General NPI Number Information
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NPI Number | 1386368397
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Entity Type | Individual
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Provider Name | GREG JOSEPH SMOLARZ II SUDPT
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Gender | Male
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 1116 SUMMIT AVE
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City | SEATTLE
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State | WA
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Zip | 98101-2831
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Country | US
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Telephone | 206-605-5805
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Fax |
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Provider Business Mailing Address
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Address Line | 24823 PACIFIC HWY S
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City | KENT
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State | WA
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Zip | 98032-5478
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Country | US
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Telephone | 253-681-0100
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CP61565198
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | CO61358694
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 229N00000X
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Taxonomy Name | Anaplastologist
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License Number | CO61358694
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MC61365506
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License Number State | WA
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