Individual
BROCK SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
9040 FITZSIMMONS DR, TACOMA, WA 98431-1000
(253) 968-2960
Mailing address
8326 JAMIESON CT SW, TUMWATER, WA 98512-2469
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
22290
MT
Other
Enumeration date
02/27/2006
Last updated
07/08/2007
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