Individual
JESSICA K SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
1330 11TH AVE, LONGVIEW, WA 98632-3817
(360) 425-6706
Mailing address
PO BOX 910, TOLEDO, WA 98591-0910
(360) 978-5407
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00157288
WA
Other
Enumeration date
04/27/2006
Last updated
07/08/2007
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