Provider Demographics
NPI:1831784529
Name:SMITH, KIANA (LAC)
Entity type:Individual
Prefix:MS
First Name:KIANA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2312 3RD AVE UNIT 709
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-1744
Mailing Address - Country:US
Mailing Address - Phone:951-473-4971
Mailing Address - Fax:
Practice Address - Street 1:12006 98TH AVE NE STE 103
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4218
Practice Address - Country:US
Practice Address - Phone:425-448-9619
Practice Address - Fax:425-448-9455
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006888-01171100000X
TXAC02081171100000X
WA61657949171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist