Individual
KYLE E SMOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9427 SW BARNES RD, STE 595, PORTLAND, OR 97225-6652
(503) 216-1060
(503) 216-1066
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD24410
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006983
—
OR
Enumeration date
01/18/2007
Last updated
11/30/2021
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