Provider Demographics
NPI:1396137816
Name:SMITHERMAN, STEPHEN JUSTIN (ND, DC, MS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JUSTIN
Last Name:SMITHERMAN
Suffix:
Gender:M
Credentials:ND, DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6204 NE HIGHWAY 99 STE B
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8746
Mailing Address - Country:US
Mailing Address - Phone:206-280-8702
Mailing Address - Fax:503-376-6600
Practice Address - Street 1:6204 NE HIGHWAY 99 STE B
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8746
Practice Address - Country:US
Practice Address - Phone:206-280-8702
Practice Address - Fax:503-376-6600
Is Sole Proprietor?:No
Enumeration Date:2015-02-19
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012763111NN1001X
WANT60832386175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
No175F00000XOther Service ProvidersNaturopath