Provider Demographics
NPI:1073862629
Name:SMOTHERS, WAYNE (DVM)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:
Last Name:SMOTHERS
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 172ND ST NE
Mailing Address - Street 2:SUITE L
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-6336
Mailing Address - Country:US
Mailing Address - Phone:360-659-0877
Mailing Address - Fax:360-659-0448
Practice Address - Street 1:3704 172ND ST NE
Practice Address - Street 2:SUITE L
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-6336
Practice Address - Country:US
Practice Address - Phone:360-659-0877
Practice Address - Fax:360-659-0448
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00002976174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian