Charles E Smith, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60190567 Issued in WA

Practice address

3670 Stone Way N Ste N271
Seattle, WA 98103-8004

Phone

(206) 834-4100

Fax

(206) 834-4131

NPI assigned

May 30, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1942401500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84909",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981246209",
            "telephone_number": "206-834-4100",
            "fax_number": "206-834-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 STONE WAY N STE N271",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038004",
            "telephone_number": "206-834-4100",
            "fax_number": "206-834-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARLES",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PY0521",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60190567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2065529",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cecilia Smith
• Celest C Smith, RN, MS, IBCLC
• Celina Star Smith, MS, CCC-SLP
• Chad Robert Smith, EMT
• Charles David Smith
• Christopher H. Smith, M.D.
• Corrine O'Sullivan Smith, CGC
• Courtney Smith
• Courtney Smith
• Courtney Alexandria Smith, MSM

• Clinical Psychologist in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; 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.