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Individual

SANDRA YVETTE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8222 BEACH WAY DR, BLAINE, WA 98230-9581
(360) 920-5318
Mailing address
8222 BEACH WAY DR, BLAINE, WA 98230-9581
(360) 920-5318

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60200301
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
60200301
RN
WA
01
60200301
RN
Enumeration date
03/11/2020
Last updated
03/11/2020
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