Individual
JASON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
3995 MARCOLA RD, SPRINGFIELD, OR 97477-7948
(541) 726-1465
(541) 726-5085
Mailing address
3995 MARCOLA RD, SPRINGFIELD, OR 97477-7948
(541) 726-1465
(541) 726-5085
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201606339NP-PP
OR
Other
Enumeration date
12/18/2006
Last updated
03/21/2017
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