Individual
BLAISE KENNETH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2811 S 102ND ST, SUITE 220, TUKWILA, WA 98168-1870
(425) 525-6800
Mailing address
2811 S 102ND ST, SUITE 220, TUKWILA, WA 98168-1870
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P1603029323
WA
Other
Enumeration date
12/22/2023
Last updated
12/22/2023
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