Individual
AVENA M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
350 TIBBLING RD, SELAH, WA 98942-9253
(509) 697-8174
Mailing address
350 TIBBLING RD, SELAH, WA 98942-9253
(509) 697-8174
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG60130338
WA
Other
Enumeration date
01/26/2010
Last updated
03/17/2011
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