Individual
STEPHANIE IRENE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1246 SW FALCON ST, PORTLAND, OR 97219-4341
(503) 421-8629
Mailing address
1644 LUCINDA AVE NE, KEIZER, OR 97303-2498
(503) 949-2818
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
A0671
OR
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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