Provider Demographics
NPI:1487752879
Name:SMITH, DALE E (PHD)
Entity type:Individual
Prefix:DR
First Name:DALE
Middle Name:E
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:VA PUGET SOUND HEALTH CARE SYSTEM
Mailing Address - Street 2:AMERICAN LAKE DIVISION
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98493-5000
Mailing Address - Country:US
Mailing Address - Phone:253-583-1670
Mailing Address - Fax:253-589-4064
Practice Address - Street 1:VA PUGET SOUND HEALTH CARE SYSTEM
Practice Address - Street 2:AMERICAN LAKE DIVISION
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493-5000
Practice Address - Country:US
Practice Address - Phone:253-583-1670
Practice Address - Fax:253-589-4064
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001573103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical