Provider Demographics
NPI:1841882321
Name:SMYTH, COURTNEY L (DNP)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:L
Last Name:SMYTH
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:DR
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:SMYTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP, ARNP
Mailing Address - Street 1:PO BOX 331
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019
Mailing Address - Country:US
Mailing Address - Phone:866-747-2455
Mailing Address - Fax:
Practice Address - Street 1:212 E CENTRAL AVE STE 240
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-6597
Practice Address - Country:US
Practice Address - Phone:509-455-8820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-06
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61127556363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily