Individual
MR. SHANE SMEDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QMHA-R, CRM, PSS-AD
Contact information
Practice address
361 YEWWOOD DR, SHADY COVE, OR 97539-9794
(458) 204-8226
Mailing address
361 YEWWOOD DR, SHADY COVE, OR 97539-9794
(458) 204-8226
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
108144
OR
Other
Enumeration date
04/10/2023
Last updated
09/11/2025
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