Individual provider Active NPI

Justin Bradley Smith, MD

  • Vascular & Interventional Radiology Physician
  • Lynnwood, WA
National Provider Identifier
1306006531
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
MD60299983 Issued in WA
Practice address
19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748
Phone
(425) 563-1500
Fax
(425) 563-1501
NPI assigned
Jun 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X M-12706 ID
Diagnostic Radiology Physician 2085R0202X MD60299983 WA
Vascular & Interventional Radiology Physician 2085R0204X M-12706 ID
Vascular & Interventional Radiology Physician 2085R0204X MD60299983 WA Primary

Addresses

Primary practice location

19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748

Mailing address

19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748
Phone (425) 563-1500

Other identifiers 7

IdentifierTypeStateIssuer
0345196OtherWAL&I-RADIA REST OF WA
2020382MedicaidWA
0345197OtherWAL&I-RADIA KING CTY
0345198OtherWAL&I-SWEDISH RADIA EDMONDS
1306006531MedicaidID
0345199OtherWAL&I-EVERGREEN RADIA
0407044OtherWAL&I-SEATTLE RADIOLOGY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140918001089 WA Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 5193961274 Reassigns benefits to 4 organizations
I20150622002705 ID Practitioner - Diagnostic Radiology 5193961274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
University of Nevada School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Oncology Associates PSGroup PAC ID 6901890243, 10 clinicians
Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

13424 E Mission Ave
Spokane Valley, WA 99216-2759
Phone (509) 462-2273

2811 Tieton Dr
Yakima, WA 98902-3761
Phone (509) 575-8000

311 S L St
Tacoma, WA 98405-3720

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

910 W 5TH Ave
Suite 801
Spokane, WA 99204-2974
Phone (509) 755-6760

Hospital & facility affiliations

  • Deaconess Medical Center Hospital, Spokane, WA, CCN 500044
  • Multicare Valley Hospital Hospital, Spokane Valley, WA, CCN 500119
  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036
  • Samaritan Hospital Hospital, Moses Lake, WA, CCN 500033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD60299983WAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Oncology Associates, PS CurrentSince Jun 1, 2025 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Aug 15, 2025 Accepting new patients
Medical Oncology Associates, P.S. CurrentSince Jun 1, 2025 Accepting new patients
Multicare Health System Current Accepting new patients
Peak Interventional Radiology, P.L.L.C. Vascular & Interventional Radiology Current Accepting new patients
Multicare Health System Diagnostic Radiology CurrentSince Jul 12, 2024 Accepting new patients
Multicare Health System CurrentSince Jul 12, 2024 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Aug 15, 2025 Accepting new patients

Locations

143 Garden Homes Dr
Colville, WA 99114
Phone (509) 684-3701

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

800 W 5th Ave
Spokane, WA 99204
Phone (509) 458-5800

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1306006531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JUSTIN",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-11",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-12706",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60299983",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "ID",
            "license": "M-12706",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WA",
            "license": "MD60299983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-RADIA REST OF WA",
            "identifier": "0345196",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2020382",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-RADIA KING CTY",
            "identifier": "0345197",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-SWEDISH RADIA EDMONDS",
            "identifier": "0345198",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306006531",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-EVERGREEN RADIA",
            "identifier": "0345199",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-SEATTLE RADIOLOGY",
            "identifier": "0407044",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

Verify at the official NPI Registry.