Individual
MR. JONATHAN ROY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II
Contact information
Practice address
149 W 12TH AVE, EUGENE, OR 97401-6215
(541) 344-0031
(541) 344-0772
Mailing address
149 W. 12TH AVE., EUGENE, OR 97401-3008
(541) 344-0031
(541) 344-0772
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
930569684
OR
101YM0800X
Mental Health Counselor
930569684
OR
Other
Enumeration date
02/25/2011
Last updated
02/06/2013
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