Provider Demographics
NPI:1295862191
Name:SMITH, STEVEN DWANE (DO)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:DWANE
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:820 HARVEY RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4247
Mailing Address - Country:US
Mailing Address - Phone:253-833-3278
Mailing Address - Fax:253-804-4620
Practice Address - Street 1:820 HARVEY RD
Practice Address - Street 2:SUITE F
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4247
Practice Address - Country:US
Practice Address - Phone:253-833-3278
Practice Address - Fax:253-804-4620
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAOP00000853207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine