Individual
KENNETH RAY SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7610 40TH ST W STE 300, UNIVERSITY PLACE, WA 98466-3834
(253) 830-6242
Mailing address
7610 40TH ST W STE 300, UNIVERSITY PLACE, WA 98466-3834
(253) 830-6242
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/21/2019
Last updated
02/24/2022
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