Individual
HEATHER M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3202 SE 82ND AVE, PORTLAND, OR 97266-2004
(503) 777-5995
(503) 777-8005
Mailing address
3202 SE 82ND AVE, PORTLAND, OR 97266-2004
(503) 777-5995
(503) 777-8005
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
200550118NP
OR
363LF0000X
Family Nurse Practitioner
Primary
200550118NP
OR
Other
Enumeration date
10/06/2006
Last updated
10/09/2009
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