Organization
EMILIA SMITH
Active
Other names
Sisu Lactation
Organization subpart
No
Provider details
NPI number
Authorized official
EMILIA MEGTALEENA SMITH IBCLC (LACTATION CONSULTANT)
(503) 805-1143
Entity
Organization
Contact information
Practice address
1424 NE 74TH AVE, PORTLAND, OR 97213-6123
(503) 805-1143
Mailing address
1424 NE 74TH AVE, PORTLAND, OR 97213-6123
(503) 805-1143
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-47067
OR
Other
Enumeration date
03/04/2014
Last updated
03/04/2014
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