Provider Demographics
NPI:1972575108
Name:SMELTZ, ERIC TECUMSEH (PSYD PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:TECUMSEH
Last Name:SMELTZ
Suffix:
Gender:M
Credentials:PSYD PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7805 S ASSEMBLY RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-5940
Mailing Address - Country:US
Mailing Address - Phone:509-981-9999
Mailing Address - Fax:
Practice Address - Street 1:7805 S ASSEMBLY RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-5940
Practice Address - Country:US
Practice Address - Phone:509-981-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY 1309103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical