Individual
MARY ELIZABETH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
11855SW RIDGECREST DR, #209, BEAVERTON, OR 97008
(503) 626-1950
Mailing address
11855SW RIDGECREST DR, BEAVERTON, OR 97008
(503) 626-1950
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
1490
OR
Other
Enumeration date
02/07/2013
Last updated
02/07/2013
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