Individual
TIMOTHY L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-5674
Mailing address
3181 SW SAM JACKSON PARK RD, PV-01, PORTLAND, OR 97239-3011
(503) 494-7413
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD26015
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213578
—
OR
Enumeration date
08/03/2006
Last updated
06/24/2011
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