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Individual

JESSICA J. SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
501 IDAHO RD, PALOUSE, WA 99161-8704
(406) 852-6969
Mailing address
501 IDAHO RD, PALOUSE, WA 99161-8704
(406) 852-6969

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
LP60909039
WA
174N00000X
Lactation Consultant (Non-RN)
Primary
374J00000X
Doula

Other

Enumeration date
01/22/2021
Last updated
02/04/2021
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