Individual
ROBIN C. BLAKESLEE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
12566 SW MAIN ST, TIGARD, OR 97223-6129
(503) 799-9543
Mailing address
10440 SW PAULINA DR, TUALATIN, OR 97062-8550
(503) 267-4977
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10871
OR
Other
Enumeration date
12/10/2009
Last updated
10/31/2014
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