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Individual

AARISA ELYSIANNE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
443 NE KNOTT ST # 6, PORTLAND, OR 97212-3108
(760) 613-5022
Mailing address
4306 SE WASHINGTON ST, MILWAUKIE, OR 97222-5356
(760) 613-5022

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
LMT 15732
OR
172M00000X
Mechanotherapist
MA 60043874
WA

Other

Enumeration date
03/11/2011
Last updated
08/16/2021
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