Individual
JAY S SMITHERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2555 MARVIN RD NE, PMG SW WA HAWKS PRAIRIE IM, LACEY, WA 98516-3138
(360) 923-4600
(360) 923-4663
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(360) 486-6508
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD60003286
WA
Other
Enumeration date
10/24/2005
Last updated
03/24/2021
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