Provider Demographics
NPI:1063733673
Name:SMITH, JODY BETH (AUD CCC-A)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:BETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:AUD CCC-A
Other - Prefix:
Other - First Name:JODY
Other - Middle Name:BETH
Other - Last Name:GUARIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD CCC-A
Mailing Address - Street 1:106 SW 332ND ST APT 1504
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-6124
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-625-7373
Practice Address - Fax:206-223-2388
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist