Individual
JANESSA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2645 PORTLAND RD NE STE 120, SALEM, OR 97301-0200
(503) 390-5637
(503) 393-3135
Mailing address
966 MONMOUTH AVE N, MONMOUTH, OR 97361-1053
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/11/2021
Last updated
05/11/2021
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