Provider Demographics
NPI:1568531200
Name:SMITH, VOREE J (MPT)
Entity Type:Individual
Prefix:
First Name:VOREE
Middle Name:J
Last Name:SMITH
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 R AVE
Mailing Address - Street 2:SUITE 210 D
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-4602
Mailing Address - Country:US
Mailing Address - Phone:360-293-2417
Mailing Address - Fax:360-293-2516
Practice Address - Street 1:1186 S BURLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-3314
Practice Address - Country:US
Practice Address - Phone:360-757-9018
Practice Address - Fax:360-757-9019
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008463225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8346785Medicaid
WA0158138OtherDEPT OF LABOR & INDUSTRIE
WA8346785Medicaid