Tara L Smyth

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

CG70040495 Issued in WA

Practice address

2428 W Reynolds Ave
Centralia, WA 98531-4554

Phone

(360) 330-9044

Fax

(360) 736-0689

NPI assigned

Sep 3, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1043190846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 W REYNOLDS AVE",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985314554",
            "telephone_number": "360-330-9044",
            "fax_number": "360-736-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 W REYNOLDS AVE",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985314554",
            "telephone_number": "360-330-9044",
            "fax_number": "360-736-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYTH",
        "first_name": "TARA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG70040495",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "CG70040495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Floyd D Smith, M.D.
• Hilary Smith, PHARM.D.
• Rachael Nicole Smith, MA60495835
• Ryan Matthew Smith
• Samuel Scott Smith, BA, AAC
• Caiden J Sobolesky-Gammon
• Behrooz Rufino Soleimani, ARNP, DNP
• Jaekyung Song, M.D.
• Gregory A Sonntag, P.T.
• Glenn Sons Jr., PA-C

• Peer Specialist in Centralia, WA
• Providers in Centralia, WA by specialty
• Peer Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.