Individual
DIANE K. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(800) 452-3563
Mailing address
PO BOX 69024, 1024 SE REX, PORTLAND, OR 97239-0024
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
476
OR
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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