Individual
ANNISSA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11611 NE AINSWORTH CIR, PORTLAND, OR 97220-9017
(503) 257-1732
Mailing address
5393 SW DOVER CT, PORTLAND, OR 97225-1013
(503) 257-1732
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201240125RN
OR
Other
Enumeration date
12/11/2025
Last updated
12/11/2025
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