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General NPI Number Information
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NPI Number | 1679119663
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Entity Type | Individual
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Provider Name | SHARLA J SMITH LPN
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Gender | Female
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Dates
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Enumeration Date | 11/25/2019
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 9930 EVERGREEN WAY STE Z150
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City | EVERETT
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State | WA
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Zip | 98204-3889
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Country | US
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Telephone | 425-347-5121
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Fax |
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Provider Business Mailing Address
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Address Line | 5700 172ND ST NE
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City | ARLINGTON
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State | WA
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Zip | 98223-7742
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Country | US
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Telephone | 360-631-5548
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Fax | 360-654-0420
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LP60962008
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License Number State | WA
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