Individual
GARRETT AUSTIN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
6828 SE HOLGATE BLVD, PORTLAND, OR 97206-3504
(503) 805-7268
Mailing address
6433 SE 125TH PL, PORTLAND, OR 97236-4908
(503) 805-7268
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
24-CRM-2920
OR
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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