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Individual

JEREMY SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1201 S MILLER ST, WENATCHEE, WA 98801-3201
(509) 662-1511
Mailing address
1201 S MILLER ST, WENATCHEE, WA 98801-3201
(509) 662-1511

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD60259685
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1699988832
WA
01
289526
LNI
WA
01
P01775112
RR MEDICARE PTAN WVH
WA
Enumeration date
05/07/2007
Last updated
02/27/2017
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