Individual
SMITA JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
19020 33RD AVE W, SUITE 210, LYNNWOOD, WA 98036-4746
(425) 563-1500
(425) 563-1374
Mailing address
19020 33RD AVE W, SUITE 210, LYNNWOOD, WA 98036-4746
(425) 563-1500
(425) 563-1374
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00040833
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011101
—
WA
01
—
334238
LNI PROVIDER ID
WA
01
—
334242
LNI PROVIDER ID
WA
01
—
334243
LNI PROVIDER ID
WA
01
—
334244
LNI PROVIDER ID
WA
05
—
8317497
—
WA
Enumeration date
06/27/2006
Last updated
02/05/2015
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