Individual
DANIEL RAVEN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3400 STATE ST STE G704, SALEM, OR 97301-5105
(503) 378-7434
Mailing address
16083 SW UPPER BOONES FERRY RD STE 300, PORTLAND, OR 97224-7736
(503) 443-6156
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
11/16/2022
Last updated
11/16/2022
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