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Individual

ALLISYN NICOLE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT, DPT

Contact information

Practice address
12250 SW GARDEN PL, PORTLAND, OR 97223-8246
(503) 684-7246
(503) 624-0724
Mailing address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4391
OR
225100000X
Physical Therapist
PT26468
CA

Other

Enumeration date
08/01/2006
Last updated
04/17/2009
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