1:11 Therapeutics PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

1:11 THERAPEUTICS PLLC

Practice address

7500 Banner Way NE
Seattle, WA 98115-4176

Phone

(818) 515-7991

NPI assigned

Mar 14, 2026

Organization subpart

No

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

Authorized official

Name

Dr. Derrick Wayne Smith, MDNPI 1750546412

Title

Ceo

Phone

(818) 515-7991

Specialties & licenses 1

Addresses

Tax ID family

111 Therapeutics PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Brown Sugar Health LLC

  • Medical Specialty Clinic/Center
  • Bossier City, LA
  • NPI 1013732940
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Derrick Wayne Smith, MD, LMHCA, MA

  • Psychiatry Physician
  • Seattle, WA
  • NPI 1750546412

  Psychiatry

  NPD Authorized official

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

{
    "created_epoch": "1773446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773446400000",
    "number": "1992652283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 BROMPTON LN",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711118208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 BANNER WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981154176",
            "telephone_number": "818-515-7991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1:11 THERAPEUTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-14",
        "last_updated": "2026-03-14",
        "certification_date": "2026-03-14",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-515-7991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 1918 Winter Street Operating Co LLC

• All providers in Seattle, WA
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.