Smith, Patrick Kelly

Smith, Patrick Kelly is an individual health care provider with primary practice located at 20200 54Th Ave W , Lynnwood WA 98036-6318. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Smith, Patrick Kelly can be contacted via phone (425) 672-6400.

Contact Information

Primary practice address
20200 54Th Ave W Lynnwood WA 98036-6318
Phone: (425) 672-6400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 5601004116 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601004116 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA60940050 Washington

Profile Details

NPI number 1124016951
LBN Legal business name Smith, Patrick Kelly
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2005
Last updated May 5th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124016951 NPPES
Other 142901 GREAT LAKES HEALTH PLAN
Other 381908328 GREAT LAKES HEALTH PLAN
Other 201 GREAT LAKES HEALTH PLAN
Other 3381330 GREAT LAKES HEALTH PLAN

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