Provider Demographics
NPI:1891344180
Name:SMITH, AUBREY CHASE (DPT)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:CHASE
Last Name:SMITH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1789
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-1789
Mailing Address - Country:US
Mailing Address - Phone:360-428-6677
Mailing Address - Fax:360-428-7635
Practice Address - Street 1:2226 MARKET ST STE C
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-5451
Practice Address - Country:US
Practice Address - Phone:360-428-6677
Practice Address - Fax:360-428-7635
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT609837472251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic