Individual
JHAIZMINE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
333 NE RUSSELL ST, PORTLAND, OR 97212-3762
(503) 334-9955
(833) 351-2566
Mailing address
4110 NE 122ND AVE STE 110, PORTLAND, OR 97230-1359
(503) 334-9955
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
A10288
OR
1041C0700X
Clinical Social Worker
A10288
OR
1041C0700X
Clinical Social Worker
Primary
L11688
OR
Other
Enumeration date
11/20/2020
Last updated
09/16/2024
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