Individual
WILLIE LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1116 SUMMIT AVE, SEATTLE, WA 98101-2831
(206) 323-0930
Mailing address
1116 SUMMIT AVE, SEATTLE, WA 98101-2831
(206) 323-0930
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91-0882971
—
WA
Enumeration date
07/12/2017
Last updated
07/21/2022
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