Provider Demographics
NPI:1801385844
Name:SMITH, DEANNA KRYSTINE
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:KRYSTINE
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19021 67TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-5345
Mailing Address - Country:US
Mailing Address - Phone:253-592-0592
Mailing Address - Fax:
Practice Address - Street 1:19021 67TH AVE SE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98296-5345
Practice Address - Country:US
Practice Address - Phone:253-592-0592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula