Individual
BETHANY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
559 GLATT CIR STE 1, WOODBURN, OR 97071-9675
(503) 981-4591
(503) 982-3308
Mailing address
559 GLATT CIR STE 1, WOODBURN, OR 97071-9675
(503) 981-4591
(503) 982-3308
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
20238
OR
Other
Enumeration date
12/05/2013
Last updated
12/05/2013
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