Individual
TANI SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1265 SW PACIFIC AVE, CHEHALIS, WA 98532-3624
(360) 807-7245
Mailing address
1265 SW PACIFIC AVE, CHEHALIS, WA 98532-3624
(360) 807-7245
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60172982
WA
Other
Enumeration date
02/10/2015
Last updated
02/10/2015
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