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Individual

LEA PURISIMA SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1010 SW COAST HWY, SUITE 203, NEWPORT, OR 97365-5288
(541) 265-4947
(541) 574-7670
Mailing address
1510 SE STURDEVANT RD, TOLEDO, OR 97391-2125
(541) 265-0581
(541) 574-6252

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201605283RN
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
201605283RN
RN-OREGON
OR
Enumeration date
07/08/2016
Last updated
09/29/2016
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