Individual
DR. MARK DOUGLAS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1040 NW 22ND AVE, SUITE 500, PORTLAND, OR 97210-3057
(503) 227-5050
Mailing address
1040 NW 22ND AVE, SUITE 500, PORTLAND, OR 97210-3057
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/06/2008
Last updated
08/06/2008
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