Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | TR60253483 | WA |
N | 207RH0003X | Hematology & Oncology | TR60253483 | WA |
NPI | 1346525979 |
---|---|
Provider Name | Laura Sophia Connelly-Smith |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98109-4405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2011 |
Last Update Date | 14/10/2011 |