Individual
THOMAS L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN, LMT
Contact information
Practice address
315 S JOSEPHINE AVE, ROSALIA, WA 99170-9570
(503) 307-1886
Mailing address
315 S JOSEPHINE AVE, ROSALIA, WA 99170-9570
(503) 307-1886
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60202622
WA
225700000X
Massage Therapist
MA00009284
WA
Other
Enumeration date
07/12/2023
Last updated
07/12/2023
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