Individual
DR. MARK ALLEN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
15821 SR 525, LANGLEY, WA 98260-9780
(360) 321-4779
(360) 321-4782
Mailing address
15821 SR 525, LANGLEY, WA 98260-9780
(360) 321-4779
(360) 321-4782
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001519
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2080307
—
WA
Enumeration date
09/20/2005
Last updated
10/22/2007
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