Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | G55642 | CA |
Y | 2081P2900X | Pain Medicine | G55642 | CA |
NPI | 1376510396 |
---|---|
Provider Name | Harry G Smolen |
First Address | Dupont, WA 98327 |
Second Address | Tacoma, WA 98431-1100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 03/04/2019 |