Provider Demographics
NPI:1841374071
Name:SMITH, GRAEME P (DC)
Entity type:Individual
Prefix:DR
First Name:GRAEME
Middle Name:P
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1487 NE DAWN RD
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-3122
Mailing Address - Country:US
Mailing Address - Phone:360-373-8899
Mailing Address - Fax:360-373-8891
Practice Address - Street 1:1100 WHEATON WAY
Practice Address - Street 2:SUITE B
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310
Practice Address - Country:US
Practice Address - Phone:360-373-8899
Practice Address - Fax:360-373-8891
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034396111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP00244901OtherRAILROAD MEDICARE
WA0188951OtherDEPT OF LABOR & INDUSTRY
WA606889300OtherFEDERAL LABOR & INDUSTRY
WA05061096701OtherKITSAP PHYSICIANS SERVICE
WA606889300OtherFEDERAL LABOR & INDUSTRY