Individual
MR. MAX GABRIEL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
8348 SE 140TH CT, PORTLAND, OR 97236-6601
(971) 221-4266
Mailing address
8348 SE 140TH CT, PORTLAND, OR 97236-6601
(971) 221-4266
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M13116
OR
Other
Enumeration date
04/18/2022
Last updated
04/18/2022
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