Provider Demographics
NPI:1871736041
Name:SMITH, KYLIE ANN (DO)
Entity type:Individual
Prefix:DR
First Name:KYLIE
Middle Name:ANN
Last Name:SMITH
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Gender:F
Credentials:DO
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Mailing Address - Street 1:4011 TALBOT RD S
Mailing Address - Street 2:SUITE 430
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5773
Mailing Address - Country:US
Mailing Address - Phone:425-251-3454
Mailing Address - Fax:425-264-3201
Practice Address - Street 1:4011 TALBOT RD S
Practice Address - Street 2:SUITE 430
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5773
Practice Address - Country:US
Practice Address - Phone:425-251-3454
Practice Address - Fax:425-264-3201
Is Sole Proprietor?:No
Enumeration Date:2009-04-17
Last Update Date:2012-10-12
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Provider Licenses
StateLicense IDTaxonomies
WAOP 60286079207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology