Individual
STACEY MARIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1816 N 155TH ST, SHORELINE, WA 98133-6014
(206) 356-8473
Mailing address
1816 N 155TH ST, SHORELINE, WA 98133-6014
(206) 356-8473
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
MA00015667
WA
Other
Enumeration date
05/22/2008
Last updated
05/22/2008
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