Individual
RUSSELL M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
211 SKYLINE DRIVE, WHITE SALMON, WA 98672
(509) 493-1101
Mailing address
16506 SW 29TH STREET APT K93, VANCOUVER, WA 98683
(509) 493-1101
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00029546
WA
207P00000X
Emergency Medicine Physician
MD14453
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105593
—
OR
05
—
2081666
—
NV
05
—
8117327
—
WA
05
—
XPY196668
—
CA
Enumeration date
03/14/2006
Last updated
03/09/2012
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