Individual
EMLIA MEGTALEENA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDM, CPM
Contact information
Practice address
1424 NE 74TH AVE, PORTLAND, OR 97213-6123
(503) 805-1143
Mailing address
1424 NE 74TH AVE, PORTLAND, OR 97213-6123
(503) 805-1143
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
DEM-LD-10170627
OR
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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