Individual
KELLY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
401 S MAIN ST, DEER PARK, WA 99006-8238
(509) 444-8200
(509) 434-0392
Mailing address
611 N IRON BRIDGE WAY, SPOKANE, WA 99202-4932
(509) 444-8888
(509) 444-7806
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60565725
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH60565725
PHARMACIST
WA
05
—
PH60565725
—
WA
Enumeration date
08/29/2016
Last updated
01/30/2024
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