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Individual

MRS. SHANNON KATHLEEN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
9040 JACKSON AVENUE, ATTN MCHK-CLQ-C, MADIGAN ARMY MEDICAL CENTER, TACOMA, WA 98431-1000
(253) 967-9818
(253) 967-3639
Mailing address
9040 JACKSON AVENUE, ATTN MCHK-CLQ-C, MADIGAN ARMY MEDICAL CENTER, TACOMA, WA 98431-1000
(253) 967-9818

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00046917
WA

Other

Enumeration date
04/19/2016
Last updated
04/19/2016
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