Individual
BERNEY SMITH ZEPEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1045 TEVIOT PL NW, SALEM, OR 97304-3111
(503) 779-5090
Mailing address
1045 TEVIOT PL NW, SALEM, OR 97304-3111
(503) 779-5090
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
235236
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104513092
—
OR
Enumeration date
04/18/2023
Last updated
04/20/2023
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