Smith, Jacquelin
Smith, Jacquelin is an individual health care provider with primary practice located at 2525 Ne 139Th St , Vancouver WA 98686-2719. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Smith, Jacquelin can be contacted via phone (360) 397-1500.Contact Information
Primary practice address
2525 Ne 139Th St
Vancouver WA 98686-2719
Phone: (360) 397-1500
Fax: (360) 604-1771
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD00029450 | Washington |
Profile Details
| NPI number | 1598708158 |
|---|---|
| LBN Legal business name | Smith, Jacquelin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2006 |
| Last updated | Dec 17th, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598708158 | NPPES |
| Washington | MEDICAID | 8135485 |
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