Individual
DR. JUSTIN BRADLEY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1501
Mailing address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1374
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
M-12706
ID
2085R0202X
Diagnostic Radiology Physician
MD60299983
WA
2085R0204X
Vascular & Interventional Radiology Physician
M-12706
ID
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD60299983
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0345196
L&I-RADIA REST OF WA
WA
01
—
0345197
L&I-RADIA KING CTY
WA
01
—
0345198
L&I-SWEDISH RADIA EDMONDS
WA
01
—
0345199
L&I-EVERGREEN RADIA
WA
01
—
0407044
L&I-SEATTLE RADIOLOGY
WA
05
—
1306006531
—
ID
05
—
2020382
—
WA
Enumeration date
06/11/2008
Last updated
03/07/2024
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