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Individual

DR. GARY E SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
10725 SE 256TH ST, STE 4, KENT, WA 98030-8285
(253) 852-8880
(253) 479-0104
Mailing address
10725 SE 256TH ST, STE 4, KENT, WA 98030-8285
(253) 852-8880
(253) 479-0104

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001313
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2104909
WA
01
SM0620
BCBS
WA
Enumeration date
08/17/2005
Last updated
10/14/2008
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