Individual
AUSTIN W SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
10123 SE MARKET ST, PORTLAND, OR 97216-2532
(503) 257-2500
Mailing address
10123 SE MARKET ST, PORTLAND, OR 97216-2532
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
10014902
OR
390200000X
Student in an Organized Health Care Education/Training Program
201705526RN
OR
Other
Enumeration date
07/02/2020
Last updated
01/09/2024
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