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Individual

JACOB DOUGLAS SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
101 W 8TH AVE, SPOKANE, WA 99204-2307
(406) 459-3416
Mailing address
3815 HIAWATHA AVE UNIT 335, MINNEAPOLIS, MN 55406-4497
(406) 459-3416

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
03/19/2024
Last updated
03/19/2024
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