Individual
COLTEN J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10123 SE MARKET ST, PORTLAND, OR 97216-2532
(503) 251-6155
(503) 261-6769
Mailing address
10123 SE MARKET ST, PORTLAND, OR 97216-2532
(503) 251-6155
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
6240
AZ
363A00000X
Physician Assistant
Primary
PA197416
OR
Other
Enumeration date
10/27/2015
Last updated
08/31/2022
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