Individual
DR. GAVIN HALL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
7308 BRIDGEPORT WAY W, SUITE 201, LAKEWOOD, WA 98499-2777
(253) 582-7257
(253) 582-0687
Mailing address
805 MADISON ST, SUITE 901, SEATTLE, WA 98104-1172
(206) 264-8100
(206) 264-8689
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO00000791
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8431215
—
WA
01
—
CJ4574
RAILROAD MEDICARE
WA
01
—
P00245950
RAILROAD MEDICARE BILLING
WA
Enumeration date
03/28/2006
Last updated
10/20/2011
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