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Individual

COLLEEN E SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
551 E HAWTHORNE RD, SPOKANE, WA 99218-1417
(509) 944-8910
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(509) 944-8910

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
WA
363AM0700X
Medical Physician Assistant
Primary
PA60197705
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1095451
PA CERTIFICATE
WA
01
PA60197705
STATE LICENSE
WA
Enumeration date
01/17/2011
Last updated
02/05/2025
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