Provider Demographics
NPI:1952466450
Name:SMITH, DANIEL ERIC (CRNA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ERIC
Last Name:SMITH
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 W FRANCIS AVE # 213
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6834
Mailing Address - Country:US
Mailing Address - Phone:509-710-2545
Mailing Address - Fax:253-833-8947
Practice Address - Street 1:1818 W FRANCIS # 213
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6834
Practice Address - Country:US
Practice Address - Phone:509-710-2545
Practice Address - Fax:509-465-8757
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004924163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
9617341OtherRAILROAD MEDICARE
WA107583OtherLABOR & INUSTRIES
WA9617341Medicaid
WASM7234OtherASURIS
9617341OtherRAILROAD MEDICARE