Individual
SYBILLE GOLDBACK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
11311 BRIDGEPORT WAY SW, STE 100, LAKEWOOD, WA 98499-3071
(253) 581-6688
(253) 512-2894
Mailing address
11311 BRIDGEPORT WAY SW, STE 100, LAKEWOOD, WA 98499-3071
(253) 581-6688
(253) 512-2894
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
AP30005537
WA
363LF0000X
Family Nurse Practitioner
Primary
AP30005537
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0193324
STATE LICENSE
—
01
—
8929404
STATE CRIME VICTIMS
—
05
—
9627324
—
WA
01
—
P00306321
RAILROAD
WA
Enumeration date
07/18/2006
Last updated
11/18/2011
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