MEDICARE: ASHLEY SMITH MA

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1952724478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY SMITH MA

Provider Business Mailing Address
First Line	:	16229 PRAIRIE CREEK LOOP SE
Second Line	:
City	:	YELM
State	:	WA
Zip	:	98597-7603
Country	:	US
Telephone Number	:	253-740-8742
Fax Number	:

Provider Business Practice Location Address
First Line	:	6512 20TH STREET CT W STE B1
Second Line	:
City	:	FIRCREST
State	:	WA
Zip	:	98466-6212
Country	:	US
Telephone Number	:	253-740-8742
Fax Number	:

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

Provider Enumeration Date	:	02/04/2014
Last Update Date	:	02/05/2014

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Directions to “ ASHLEY SMITH MA” Practice Location

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