Individual
MARK W SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1145 BROADWAY, SEATTLE, WA 98122-4201
(206) 329-1760
Mailing address
1145 BROADWAY, SEATTLE, WA 98122-4201
(206) 329-1760
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00045081
WA
208M00000X
Hospitalist Physician
Primary
MD00045081
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039581
LABOR AND INDUSTRIES #
WA
01
—
0138SM
BLUE SHIELD #
WA
05
—
1002568
—
WA
05
—
A8430746
—
WA
01
—
US7684713
AETNA SPECIALIST PIN
WA
Enumeration date
10/10/2006
Last updated
05/10/2017
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