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Individual

ELENIE L SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM, NP, NMNP PP

Contact information

Practice address
9427 SW BARNES RD, SUITE 395, PORTLAND, OR 97225-6652
(503) 216-2602
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
200650050NP NMNP PP
OR
367A00000X
Advanced Practice Midwife
Primary
200650050NP NMNP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
028177
OR
Enumeration date
07/12/2006
Last updated
03/25/2021
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