Individual
MS. JESSICA BRYCE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.A.S, P.S.S, C.H.W
Contact information
Practice address
195 W 12TH AVE, EUGENE, OR 97401-3408
(541) 762-4325
(541) 684-4156
Mailing address
687 CHESHIRE AVE, EUGENE, OR 97402-5060
(541) 343-2993
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50066493
—
OR
Enumeration date
08/08/2013
Last updated
11/28/2017
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