Individual
JESSICA HANNE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
THW
Contact information
Practice address
1580 NW 17TH ST, CORVALLIS, OR 97330-2532
(541) 360-3195
Mailing address
1580 NW 17TH ST, CORVALLIS, OR 97330-2532
(541) 360-3195
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
THW000004389
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
THW000004389
—
OR
Enumeration date
06/09/2020
Last updated
06/09/2020
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