Individual
KATE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSS
Contact information
Practice address
1190 BROADWAY ST NE, SALEM, OR 97301-1141
(503) 393-4273
Mailing address
1069 OAKWOOD ST NE, KEIZER, OR 97303-1880
(503) 507-4588
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000108652
OR
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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