Provider Demographics
NPI:1841229242
Name:SMITH, MURRAY L (DC)
Entity Type:Individual
Prefix:DR
First Name:MURRAY
Middle Name:L
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1526 BISHOP RD SW
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-7354
Mailing Address - Country:US
Mailing Address - Phone:360-459-9000
Mailing Address - Fax:360-459-9183
Practice Address - Street 1:1526 BISHOP RD SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-7354
Practice Address - Country:US
Practice Address - Phone:360-459-9000
Practice Address - Fax:360-459-9183
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002036111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP00172865OtherGBA MEDICARE NUMBER
WA57050OtherL&I PROVIDER NUMBER
WAGAB22390Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
WAT02832Medicare UPIN