Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DE61231043 | WA |
NPI | 1053076703 |
---|---|
Provider Name | Dr. Smriti Bhatia |
First Address | Olympia, WA 98506-6101 |
Second Address | Olympia, WA 98506-6101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2021 |
Last Update Date | 07/11/2021 |