Provider Demographics
NPI:1447305701
Name:SMITH, PAMELA (ND, RN)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:ND, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 N 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-2632
Mailing Address - Country:US
Mailing Address - Phone:509-965-5750
Mailing Address - Fax:
Practice Address - Street 1:12728 GREENWOOD AVE N
Practice Address - Street 2:APT. 406
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-7996
Practice Address - Country:US
Practice Address - Phone:206-225-7252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000886175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath