Individual
JENNIFER LEE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D160128721
Contact information
Practice address
3626 FACTORIA BLVD SE, BELLEVUE, WA 98006-6128
(425) 747-4695
Mailing address
8102 48TH AVE S, SEATTLE, WA 98118-4406
(206) 497-1986
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
D160128721
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D160128721
RDA
WA
Enumeration date
12/30/2015
Last updated
12/30/2015
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