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Individual

MARI KAY EVANS-SMITH

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2525 NW LOVEJOY ST, STE 200, PORTLAND, OR 97210-2863
(503) 227-0671
(503) 227-0676
Mailing address
1502 NW GREGORY DR, VANCOUVER, WA 98665-6000
(360) 576-7626

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD17819
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
045620
OR
Enumeration date
06/22/2005
Last updated
07/08/2007
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