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Individual

LATRECIA SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPC

Contact information

Practice address
401 5TH AVE STE 400, SEATTLE, WA 98104-2377
(206) 305-7532
Mailing address
401 5TH AVE STE 400, SEATTLE, WA 98104-2377
(206) 305-7532

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CG60535135
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CG60535135
COUNSELOR AGENCY AFFILIATED REGISTRATION
WA
Enumeration date
01/24/2019
Last updated
01/24/2019
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