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Individual

MARY ANN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.N.M.

Contact information

Practice address
209 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4265
(253) 596-3300
Mailing address
PO BOX 34581, SEATTLE, WA 98124-1581
(509) 241-7349
(509) 241-7628

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
RN00068753
WA
367A00000X
Advanced Practice Midwife
Primary
AP30004003
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9627118
WA
Enumeration date
01/19/2007
Last updated
08/07/2009
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