Individual
DR. JACOB C SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1959 NE PACIFIC ST, BOX 357115, SEATTLE, WA 98195-7200
(206) 598-7200
(206) 598-7690
Mailing address
1959 NE PACIFIC ST, BOX 357115, SEATTLE, WA 98195-7115
(206) 598-7200
(206) 598-7690
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD60585551
WA
2085R0204X
Vascular & Interventional Radiology Physician
MD60585551
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2027913
—
WA
Enumeration date
04/17/2013
Last updated
11/03/2021
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