Individual
MARY EDSON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1700 NW CIVIC DR STE 310, GRESHAM, OR 97030-3774
(503) 666-8832
Mailing address
1224 NE 53RD AVE, PORTLAND, OR 97213-2858
(971) 716-4822
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L10327
OR
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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