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Individual

MRS. ELLEN RENE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS CCC-A

Contact information

Practice address
9218 151ST STREET CT E, PUYALLUP, WA 98375-6997
(253) 332-3002
Mailing address
9218 151ST STREET CT E, PUYALLUP, WA 98375-6997
(253) 332-3002

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
LD00003590
WA

Other

Enumeration date
01/02/2007
Last updated
10/12/2023
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