Provider Demographics
NPI:1326012907
Name:SMITH, ERIC BRENDAN (DO, MPH)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:BRENDAN
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:209 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4267
Mailing Address - Country:US
Mailing Address - Phone:253-596-3300
Mailing Address - Fax:253-596-3301
Practice Address - Street 1:209 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4267
Practice Address - Country:US
Practice Address - Phone:253-596-3300
Practice Address - Fax:253-596-3301
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP605891082083P0500X
COTL0006902390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine