Individual provider Active NPI

Connor Kamm Smith, PHARM D

  • Ambulatory Care Pharmacist
  • Puyallup, WA
National Provider Identifier
1568030773
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
PH61187298 Issued in WA
Practice address
11019 Canyon Rd E
Puyallup, WA 98373-3001
Phone
(425) 259-1180
Fax
(425) 595-2950
NPI assigned
Jun 14, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Pharmacist 1835P2201X PH61187298 WA Primary

Addresses

Primary practice location

11019 Canyon Rd E
Puyallup, WA 98373-3001

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

Other practice location 1

1812 S J St Ste 102
Tacoma, WA 98405-4965
Phone (425) 259-1180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH61187298WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1568030773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11019 CANYON RD E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733001",
            "telephone_number": "425-259-1180",
            "fax_number": "425-595-2950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1812 S J St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054965",
            "country_code": "US",
            "telephone_number": "425-259-1180",
            "fax_number": "425-595-2950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CONNOR",
        "middle_name": "KAMM",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-14",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "WA",
            "license": "PH61187298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.