Individual
DANIEL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
11100 SE PETROVITSKY RD APT C206, RENTON, WA 98055-5645
(706) 577-7957
Mailing address
11100 SE PETROVITSKY RD APT C206, RENTON, WA 98055-5645
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP 60443727
WA
363LG0600X
Gerontology Nurse Practitioner
AP 60443727
WA
Other
Enumeration date
03/17/2014
Last updated
03/17/2014
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