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NPI Code Detail

MEDICARE: FRAN J SMITH MSW

MEDICARE: FRAN J SMITH MSW
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
11041C0700XClinical Social WorkerLW00004474WA

General Provider Information

NPI Number : 1215022546
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRAN J SMITH MSW
Provider Business Mailing Address
First Line : 945 11TH AVE
Second Line : SUITE B
City : LONGVIEW
State : WA
Zip : 98632-2555
Country : US
Telephone Number : 360-414-8600
Fax Number : 360-636-7372
Provider Business Practice Location Address
First Line : 945 11TH AVE
Second Line : SUITE B
City : LONGVIEW
State : WA
Zip : 98632-2555
Country : US
Telephone Number : 360-414-8600
Fax Number : 360-636-7372
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 07/09/2007

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