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Individual

GARY A SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2005 W MAIN ST, BATTLE GROUND, WA 98604-4311
(360) 397-4060
(360) 666-4772
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-1913
(360) 397-1500
(360) 397-3128

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD00046149
WA
207P00000X
Emergency Medicine Physician
MD11631
OR
207Q00000X
Family Medicine Physician
Primary
MD00046149
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0238840
L & I
WA
05
026808
OR
05
8518334
WA
01
8948203
L & I CRIME VICTIMS
WA
01
P00360925
RR MEDICARE
OR
Enumeration date
06/06/2006
Last updated
09/30/2008
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