Individual
SHETAYE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6450 13TH AVE SE, SALEM, OR 97306-1454
(503) 362-0373
(503) 362-0373
Mailing address
PO BOX 18397, SALEM, OR 97305-8397
(503) 910-5648
(503) 362-0373
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
081002516RN
OR
Other
Enumeration date
04/25/2012
Last updated
04/25/2012
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