Provider Demographics
NPI:1811275571
Name:SMART, NANCY KAYE (MS, BS)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:KAYE
Last Name:SMART
Suffix:
Gender:F
Credentials:MS, BS
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:KAYE
Other - Last Name:SUNDAHL SMART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BS
Mailing Address - Street 1:2201 W DOLARWAY RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-8228
Mailing Address - Country:US
Mailing Address - Phone:509-952-5453
Mailing Address - Fax:509-925-2474
Practice Address - Street 1:2201 W DOLARWAY RD
Practice Address - Street 2:SUITE 2
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-8228
Practice Address - Country:US
Practice Address - Phone:509-952-5453
Practice Address - Fax:509-925-2474
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00002586231H00000X
WA294849E231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist