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Individual

DR. JAMES DETTMER SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-5674
Mailing address
16124 NW SAINT ANDREWS DR, PORTLAND, OR 97229-7818

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD07228
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
181966
OR
Enumeration date
08/01/2006
Last updated
12/23/2011
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