Individual
JENNIFER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3716 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97212-1111
(503) 288-8066
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 645-3581
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/06/2011
Last updated
07/06/2011
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