Provider Demographics
NPI:1679758346
Name:SMITH, AARON MICHAEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:MICHAEL
Last Name:SMITH
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Gender:M
Credentials:PSYD
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Mailing Address - Street 1:9040 JACKSON AVE
Mailing Address - Street 2:MAMC DEPARTMENT OF PSYCHOLOGY
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-1100
Mailing Address - Country:US
Mailing Address - Phone:253-968-2820
Mailing Address - Fax:253-968-3731
Practice Address - Street 1:9040 JACKSON AVE
Practice Address - Street 2:MAMC DEPARTMENT OF PSYCHOLOGY
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1100
Practice Address - Country:US
Practice Address - Phone:253-968-2820
Practice Address - Fax:253-968-3731
Is Sole Proprietor?:No
Enumeration Date:2007-12-31
Last Update Date:2016-10-31
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Provider Licenses
StateLicense IDTaxonomies
WAPY 60089685103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical