Provider Demographics
NPI:1548778756
Name:SMASAL, JOHN F (RPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:SMASAL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2969 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:WASHOUGAL
Mailing Address - State:WA
Mailing Address - Zip Code:98671-8577
Mailing Address - Country:US
Mailing Address - Phone:425-281-9591
Mailing Address - Fax:888-459-4938
Practice Address - Street 1:430 SE 192ND AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-9531
Practice Address - Country:US
Practice Address - Phone:425-281-9591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60210143183500000X
ORRPH-0012505183500000X
MO43155183500000X
OR125051835P0018X
OR00125051835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist