Individual
MELISSA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13007 NE GLISAN ST, PORTLAND, OR 97230-2545
(503) 215-7850
Mailing address
4400 NE HALSEY ST STE 200, PORTLAND, OR 97213-1545
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
201807779RN
OR
Other
Enumeration date
10/22/2019
Last updated
10/22/2019
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