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Organization

1:11 THERAPEUTICS PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DERRICK WAYNE SMITH MD (CEO)
(818) 515-7991
Entity
Organization

Contact information

Practice address
7500 BANNER WAY NE, SEATTLE, WA 98115-4176
(818) 515-7991
Mailing address
507 BROMPTON LN, BOSSIER CITY, LA 71111-8208

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Enumeration date
03/14/2026
Last updated
03/14/2026
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