MEDICARE: CARLA S SMITH MD

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	207X00000X	Orthopaedic Surgery Physician	MD00041445	WA
2	207X00000X	Orthopaedic Surgery Physician	MD24615	OR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00613589	OTHER	WA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8329633	OTHER	WA	DSHS
4	8200SM	OTHER	WA	ASURIS

General Provider Information

NPI Number	:	1336145721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA S SMITH MD

Provider Business Mailing Address
First Line	:	PO BOX 3649
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99220-3649
Country	:	US
Telephone Number	:	509-838-2531
Fax Number	:

Provider Business Practice Location Address
First Line	:	3015 SQUALICUM PKWY STE 200
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-1906
Country	:	US
Telephone Number	:	360-733-2092
Fax Number	:	360-788-6042

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	11/17/2021

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Directions to “ CARLA S SMITH MD” Practice Location

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