Individual
ETHAN LAWRENCE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1123 N EVERGREEN RD, SPOKANE VALLEY, WA 99216-1138
(509) 363-3100
(509) 363-0300
Mailing address
PO BOX 808, VERADALE, WA 99037-0808
(509) 363-3100
(509) 363-0300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1750164752
WA
Other
Enumeration date
08/15/2023
Last updated
10/30/2025
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