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Individual

SANDRA EILENE SMITH-POLING

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2112 LANDES ST, PORT TOWNSEND, WA 98368-7802
(360) 379-0841
(360) 379-0841
Mailing address
2112 LANDES ST, PORT TOWNSEND, WA 98368-7802
(360) 379-0841
(360) 379-0841

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00015974
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0115773
L&I
WA
Enumeration date
08/29/2005
Last updated
07/08/2007
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