Provider Demographics
NPI:1366612707
Name:WENDY KAY SMITH FULL CIRCLE MEDICAL CLINIC
Entity type:Organization
Organization Name:WENDY KAY SMITH FULL CIRCLE MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:509-624-6500
Mailing Address - Street 1:508 W 6TH AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2770
Mailing Address - Country:US
Mailing Address - Phone:509-624-6500
Mailing Address - Fax:509-747-5453
Practice Address - Street 1:508 W 6TH AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2770
Practice Address - Country:US
Practice Address - Phone:509-624-6500
Practice Address - Fax:509-747-5453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care