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Individual

AMANDA MARIE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
9900 SE SUNNYSIDE RD, SUNNYBROOK MEDICAL OFFICE, CLACKAMAS, OR 97015-9777
(503) 786-8435
Mailing address
5913 N COMMERCIAL AVE, PORTLAND, OR 97217-2014
(360) 461-3933

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OR PA01036
OR

Other

Enumeration date
09/05/2006
Last updated
07/10/2007
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