Provider Demographics
NPI:1639062979
Name:SMITH, DAVID LEE (PSS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LEE
Last Name:SMITH
Suffix:
Gender:M
Credentials:PSS
Other - Prefix:
Other - First Name:TWO
Other - Middle Name:
Other - Last Name:FEATHERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2205 N IRONWOOD PL
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2610
Mailing Address - Country:US
Mailing Address - Phone:208-215-1007
Mailing Address - Fax:208-666-4122
Practice Address - Street 1:2205 N IRONWOOD PL
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2610
Practice Address - Country:US
Practice Address - Phone:208-215-1007
Practice Address - Fax:208-666-4122
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist