Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Lawrence Smith

Individual provider Physician Assistant · NPI 1750164752

Ethan Lawrence Smith is a Physician Assistant in Spokane Valley, Washington. Qualified in 2025, 1 year ago. Practices with T Daniel Dibble MD PC, a 13-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
1
Licensed in
WA
In the registry since
2023
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Practice location Address checks out

1123 N Evergreen Rd
Spokane Valley, WA 99216-1138
Phone: (509) 363-3100
Fax: (509) 363-0300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA1750164752 (WA)

Record details

NPI number1750164752
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 15, 2023
Last updated in NPPESOctober 30, 2025
Certification dateOctober 30, 2025
Mailing addressPo Box 808, Veradale, WA 99037-0808

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice T Daniel Dibble Md Pc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Spokane Valley