Individual
DR. TAVIS B SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5050 NE HOYT ST, SUITE 142, PORTLAND, OR 97213-2991
(503) 215-6296
(503) 215-6459
Mailing address
5050 NE HOYT ST, SUITE 142, PORTLAND, OR 97213-2991
(503) 215-6296
(503) 215-6459
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0012266
OR
Other
Enumeration date
10/20/2010
Last updated
10/20/2010
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