Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW61219117 | WA |
NPI | 1154081776 |
---|---|
Provider Name | Julie E Smith |
First Address | Clearlake, WA 98235-0003 |
Second Address | Mount Vernon, WA 98273-4324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2021 |
Last Update Date | 22/12/2021 |