Provider Demographics
NPI:1679012421
Name:SMIRNOVA, VERONIKA Y (DNP)
Entity Type:Individual
Prefix:DR
First Name:VERONIKA
Middle Name:Y
Last Name:SMIRNOVA
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:DR
Other - First Name:VERONICA
Other - Middle Name:
Other - Last Name:SMIRNOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9082 162ND PL NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-7572
Mailing Address - Country:US
Mailing Address - Phone:425-553-9161
Mailing Address - Fax:
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-223-6826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60728018364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist