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Individual

DR. KEVIN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD, RPH

Contact information

Practice address
4560 SE INTERNATIONAL WAY, PORTLAND, OR 97222-4628
(971) 206-5205
Mailing address
9555 NW EMBER LN, PORTLAND, OR 97229-6630
(541) 350-5973

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0015532
OR

Other

Enumeration date
07/04/2018
Last updated
07/04/2018
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