Individual
KATHLEEN M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10690 NE CORNELL RD STE 220, HILLSBORO, OR 97124-9224
(503) 848-5861
Mailing address
3020 CHILDRENS WAY # MC5075, SAN DIEGO, CA 92123-4223
(858) 966-8036
(858) 966-7433
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
G55045
CA
208000000X
Pediatrics Physician
MD26976
OR
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
MD26976
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
298528
—
OR
05
—
8129355
—
WA
Enumeration date
07/21/2006
Last updated
09/23/2021
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