Individual
MS. MIMI SUE SMITH-DANIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
26788 HIGHLAND RD NE, KINGSTON, WA 98346
(360) 297-8876
(360) 297-0777
Mailing address
26788 HIGHLAND RD NE, KINGSTON, WA 98346
(360) 297-8876
(360) 297-0777
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00039969
WA
363LG0600X
Gerontology Nurse Practitioner
AP30001519
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2813SM
REGENCE
—
05
—
9633819
—
WA
Enumeration date
08/09/2006
Last updated
09/11/2025
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