Provider Demographics
NPI:1427789684
Name:SMITH, JOSHUA T (DPM)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:T
Last Name:SMITH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:34509 9TH AVE S STE 306
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8710
Mailing Address - Country:US
Mailing Address - Phone:206-242-5293
Mailing Address - Fax:253-944-4004
Practice Address - Street 1:34509 9TH AVE S STE 306
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8710
Practice Address - Country:US
Practice Address - Phone:206-242-5293
Practice Address - Fax:253-944-4004
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPODL.PL.61320523213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist