Individual
LENNY K. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
2930 MAPLE ST, EVERETT, WA 98201-3832
(425) 261-1500
Mailing address
2930 MAPLE ST, EVERETT, WA 98201-3832
(425) 261-1500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003247
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8399396
—
WA
01
—
P00734166
RAILROAD MEDICARE
WA
Enumeration date
01/02/2007
Last updated
05/06/2021
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