Individual
LAURA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1201 S MILLER ST, WENATCHEE, WA 98801-3201
(509) 662-1511
Mailing address
1201 S MILLER ST, WENATCHEE, WA 98801-3201
(509) 662-1511
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI60637038
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013377522
—
WA
01
—
P01704181
RR MEDICARE WVH
WA
Enumeration date
02/25/2016
Last updated
10/04/2016
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