Individual
EVAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
5530 ADAMS RD, TALENT, OR 97540-7701
(541) 864-0182
Mailing address
5530 ADAMS RD, TALENT, OR 97540-7701
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20987
OR
Other
Enumeration date
03/20/2015
Last updated
09/12/2016
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