Individual
DERRICK WAYNE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, LMHCA, MA
Contact information
Practice address
7500 BANNER WAY NE, SEATTLE, WA 98115-4176
(206) 427-4679
Mailing address
507 BROMPTON LN, BOSSIER CITY, LA 71111-8208
(818) 515-7991
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
102L00000X
Psychoanalyst
—
—
2084P0800X
Psychiatry Physician
Primary
MD.61597266
WA
Other
Enumeration date
07/22/2008
Last updated
11/15/2024
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