Doctor Name: | MRS. CYNTHIA JEAN SMITH |
NPI Number: | 1013098326 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PC-C |
License Number: | PA10005082 |
Business Practice Address: | 1330 Rockefeller Ave Suite 400 Everett, WA - 982011684 |
Business Phone Number: | 4252614950 |
Business Fax Number: | 4252614951 |
Mailing Address: | Po Box 3360, PORTLAND |
State: | OR |
Postal Code: | 972083360 |
Phone Number: | 8663662983 |
Fax Number: | |
NPI Enumeration Date: | 10/17/2006 |
NPI Last Update Date: | 05/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA10005082 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |