=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407384100
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FIONA LYNNE SMITH ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/25/2017
-----------------------------------------------------
Last Update Date | 12/08/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 W MERCER ST STE 104
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98119-3958
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-281-7163
-----------------------------------------------------
Fax | 206-281-5088
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 W MERCER ST STE 104
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98119-3958
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-281-7163
-----------------------------------------------------
Fax | 206-281-5088
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | AP61296774
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | RN00156629
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------