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General NPI Number Information
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NPI Number | 1386510832
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Entity Type | Individual
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Provider Name | JORDAN SMITH DPT
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Gender | Male
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Dates
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Enumeration Date | 10/13/2025
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 231 AVENUE D
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City | SNOHOMISH
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State | WA
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Zip | 98290-2744
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Country | US
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Telephone | 360-563-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 619 89TH AVE SE
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City | LAKE STEVENS
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State | WA
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Zip | 98258-6641
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Country | US
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Telephone | 425-879-2800
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 70040712
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License Number State | WA
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