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NPI Code Detail

MEDICARE: DR. MICHAEL PATRICK SMITH DNP, FNP-C

MEDICARE:  DR. MICHAEL PATRICK SMITH  DNP, FNP-C
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
1363LF0000XFamily Nurse Practitioner201807423NP-PPOR

General Provider Information

NPI Number : 1518401611
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL PATRICK SMITH DNP, FNP-C
Provider Business Mailing Address
First Line : 8919 NE 81ST ST
Second Line :
City : VANCOUVER
State : WA
Zip : 98662-2808
Country : US
Telephone Number : 360-718-0968
Fax Number :
Provider Business Practice Location Address
First Line : 1002 BELLEVUE ST SE
Second Line :
City : SALEM
State : OR
Zip : 97301-4006
Country : US
Telephone Number : 503-814-5554
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2016
Last Update Date : 08/20/2019

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Directions to “ DR. MICHAEL PATRICK SMITH DNP, FNP-C” Practice Location

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