Provider Demographics
NPI:1720288376
Name:SAINT CLAIR, NICOLE SMITH (MD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:SMITH
Last Name:SAINT CLAIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:RENEE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:161 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-6205
Mailing Address - Country:US
Mailing Address - Phone:206-328-5691
Mailing Address - Fax:
Practice Address - Street 1:161 30TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-6205
Practice Address - Country:US
Practice Address - Phone:206-328-5691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60024605207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology