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Individual

RONALD C SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C, MMSC

Contact information

Practice address
11782 SW BARNES RD, SUITE 300, PORTLAND, OR 97225-5914
(503) 214-5200
(503) 906-6613
Mailing address
11782 SW BARNES RD, SUITE 300, PORTLAND, OR 97225-5914
(503) 214-5200
(503) 906-6613

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00582
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1801043591
NPI
OR
Enumeration date
08/25/2008
Last updated
11/21/2013
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