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Individual

DR. CHARLES E SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
3670 STONE WAY N STE N271, SEATTLE, WA 98103-8004
(206) 834-4100
(206) 834-4131
Mailing address
PO BOX 84909, SEATTLE, WA 98124-6209
(206) 834-4100
(206) 834-4131

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PY0521
NV
103TC0700X
Clinical Psychologist
Primary
PY60190567
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2065529
WA
Enumeration date
05/30/2007
Last updated
03/26/2018
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