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General NPI Number Information
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NPI Number | 1972791226
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Entity Type | Organization
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Legal Business Name | VALLEY DERMATOLOGY AND SKIN CANCER CENTER
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 13512 E MANSFIELD AVE
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-1793
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Country | US
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Telephone | 509-892-2480
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Fax | 509-892-6708
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Provider Business Mailing Address
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Address Line | 13512 E MANSFIELD AVE
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-1793
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Country | US
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Telephone | 509-892-2480
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Fax | 509-892-6708
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Authorized Official
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Title or Position | OWNER
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Name | DR. SCOTT A SMITH
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Credential | D.O.
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Telephone | 509-892-2480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 602-733-981
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License Number State | WA
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