Individual
BRIAN WENDELL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1225 NE 2ND AVE, PORTLAND, OR 97232-2003
(503) 944-8000
Mailing address
3725 SE BROOKLYN ST, PORTLAND, OR 97202-1824
(206) 334-7404
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
10024800
OR
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
07/27/2021
Last updated
04/10/2024
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