Provider Demographics
NPI:1346814423
Name:SMART COMPREHENSIVE HEALTH, PLLC
Entity Type:Organization
Organization Name:SMART COMPREHENSIVE HEALTH, PLLC
Other - Org Name:SMART COMPREHENSIVE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:CARDEL
Authorized Official - Last Name:BALDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-866-4145
Mailing Address - Street 1:PO BOX 2928
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99302-2928
Mailing Address - Country:US
Mailing Address - Phone:646-202-0278
Mailing Address - Fax:
Practice Address - Street 1:811 S AUBURN ST
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-5661
Practice Address - Country:US
Practice Address - Phone:509-866-4145
Practice Address - Fax:509-866-4146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA604-732-714OtherUBIN