Individual
COLEMAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
707 NE COUCH ST, PORTLAND, OR 97232-2922
(503) 542-4603
Mailing address
4105 N HAIGHT AVE, PORTLAND, OR 97217-2919
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/23/2014
Last updated
06/23/2014
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