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Individual

MS. CONCEPCION SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6520 ELM ST SE, TUMWATER, WA 98501-5540
(360) 943-9767
Mailing address
6520 ELM ST SE, TUMWATER, WA 98501-5540
(360) 943-9767

Taxonomy

Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
218000
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
572253
PROVIDER NUMBER
WA
Enumeration date
05/07/2013
Last updated
05/07/2013
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