MEDICARE: MS. LAURA S. SMITH LAURA S. SMITH, M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	LL00003617	WA

General Provider Information

NPI Number	:	1053519744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA S. SMITH LAURA S. SMITH, M.S.

Provider Business Mailing Address
First Line	:	7683 SE 27TH ST
Second Line	:	#127
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2804
Country	:	US
Telephone Number	:	206-228-8530
Fax Number	:	206-568-8530

Provider Business Practice Location Address
First Line	:	7683 SE 27TH ST
Second Line	:	#127
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2804
Country	:	US
Telephone Number	:	206-228-8530
Fax Number	:	206-568-8530

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2007
Last Update Date	:	07/08/2007

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