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General NPI Number Information
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NPI Number | 1477788016
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Entity Type | Individual
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Provider Name | CANDACE SMART M.S.
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Gender | Female
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Dates
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Enumeration Date | 05/27/2009
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 9340 NE 76TH ST
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City | VANCOUVER
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State | WA
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Zip | 98662-3721
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Country | US
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Telephone | 360-253-4912
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Fax | 360-253-5170
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Provider Business Mailing Address
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Address Line | 5803 N ELGIN ST
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City | SPOKANE
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State | WA
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Zip | 99205-6933
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Country | US
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Telephone | 360-708-0977
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH60043810
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License Number State | WA
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