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Individual

MALLORIE K SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AUD

Contact information

Practice address
111 S 13TH ST, MOUNT VERNON, WA 98274-4105
(360) 336-2178
(360) 336-2642
Mailing address
1400 E KINCAID ST, MOUNT VERNON, WA 98274-4127
(360) 814-6451
(360) 445-8592

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
LD60675180
WA
237600000X
Audiologist-Hearing Aid Fitter
LD60675180
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LD60675180
WA STATE LICENSE NUMBER
WA
Enumeration date
10/02/2012
Last updated
02/08/2022
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