Individual
LAURA HOVERSON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4004 KRUSE WAY PL STE 300, LAKE OSWEGO, OR 97035-2479
(503) 216-1712
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62373
OR
225100000X
Physical Therapist
PT60660142
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500739522
—
OR
Enumeration date
09/13/2016
Last updated
12/14/2020
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