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Individual

DR. WAYNE S SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
1211 N 20TH AVE, PASCO, WA 99301
(509) 547-1759
Mailing address
1211 N 20TH AVE, PASCO, WA 99301
(509) 547-1759

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00002790
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0005162299
AETNA
WA
01
146894146896
PREMERA BLUE CROSS
WA
05
2020519
WA
01
36281
LABOR & INDUSTRIES
WA
01
653633
ACN
WA
01
911678952F001
PREMERA BLUE CROSS FEP
WA
01
93621468940001
PREMERA BC NASCO
WA
Enumeration date
11/08/2006
Last updated
07/08/2007
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