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NPI Code Detail

MEDICARE: EMILY JOAN SMITH

MEDICARE: EMILY JOAN SMITH
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1114693264
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY JOAN SMITH
Provider Business Mailing Address
First Line : 331 NE THORNTON PL
Second Line :
City : SEATTLE
State : WA
Zip : 98125-8021
Country : US
Telephone Number : 206-520-2405
Fax Number : 206-520-2450
Provider Business Practice Location Address
First Line : 331 NE THORNTON PL
Second Line :
City : SEATTLE
State : WA
Zip : 98125-8021
Country : US
Telephone Number : 206-520-2405
Fax Number : 206-520-2450
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2021
Last Update Date : 03/21/2023

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Directions to “ EMILY JOAN SMITH ” Practice Location

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