Individual
MATTIAS WADE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
72C CENTENNIAL LOOP STE 100, EUGENE, OR 97401-2453
(541) 972-1824
Mailing address
72C CENTENNIAL LOOP STE 100, EUGENE, OR 97401-2453
(541) 972-1824
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
105411
OR
Other
Enumeration date
02/27/2025
Last updated
02/27/2025
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