Provider Demographics
NPI:1336681303
Name:SMITH, ZOE E (LMP)
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:E
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17528 MERIDIAN E
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375
Mailing Address - Country:US
Mailing Address - Phone:253-445-9030
Mailing Address - Fax:253-445-9031
Practice Address - Street 1:1707 3RD ST SE
Practice Address - Street 2:SUITE A
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372
Practice Address - Country:US
Practice Address - Phone:253-200-2355
Practice Address - Fax:253-200-2977
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMA60708328225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist